Provider Demographics
NPI:1417135856
Name:KANE COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:KANE COUNTY HEALTH DEPARTMENT
Other - Org Name:COUNTY OF KANE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:630-208-3140
Mailing Address - Street 1:1240 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1450
Mailing Address - Country:US
Mailing Address - Phone:630-208-3140
Mailing Address - Fax:630-208-5147
Practice Address - Street 1:1240 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1450
Practice Address - Country:US
Practice Address - Phone:630-208-3801
Practice Address - Fax:630-208-5147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36600658003Medicaid