Organization
KANKAKEE INTERNAL MEDICINE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL K SHAH (PRESIDENT)
(630) 952-1412
Entity
Organization
Contact information
Practice address
7641 NEWFIELD LN, TINLEY PARK, IL 60487-5539
(630) 952-1412
(630) 952-1447
Mailing address
7641 NEWFIELD LN, TINLEY PARK, IL 60487-5539
(630) 952-1412
(630) 952-1447
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0361058
IL
Other
Enumeration date
09/22/2008
Last updated
09/22/2008
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