Basic Information
| Provider Information | |||||||||
| NPI: | 1104261494 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KENDALL COUNTY HEALTH DEPARTMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 811 W JOHN ST | ||||||||
| Address2: | |||||||||
| City: | YORKVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605609249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305539100 | ||||||||
| FaxNumber: | 6305530167 | ||||||||
| Practice Location | |||||||||
| Address1: | 811 W JOHN ST | ||||||||
| Address2: | |||||||||
| City: | YORKVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605609249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305539100 | ||||||||
| FaxNumber: | 6305530167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2013 | ||||||||
| LastUpdateDate: | 05/01/2013 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | TOM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATIONS ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6305538027 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251K00000X | 041151527 | IL | Y | Agencies | Public Health or Welfare |
No ID Information.