Provider Demographics
NPI:1073208856
Name:FAMILY HEALTHCARE CLINIC, PLLC
Entity Type:Organization
Organization Name:FAMILY HEALTHCARE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:STROHL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:217-259-2987
Mailing Address - Street 1:15826 S LA GRANGE RD # 151
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-7793
Mailing Address - Country:US
Mailing Address - Phone:217-259-2987
Mailing Address - Fax:773-595-3912
Practice Address - Street 1:20325 S GRACELAND LN UNIT A
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9047
Practice Address - Country:US
Practice Address - Phone:312-489-6756
Practice Address - Fax:773-595-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care