Provider Demographics
NPI:1790259026
Name:SK HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SK HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:319-321-3605
Mailing Address - Street 1:2664 LOOKOUT POINT CIR NE
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9700
Mailing Address - Country:US
Mailing Address - Phone:319-343-1696
Mailing Address - Fax:319-359-4123
Practice Address - Street 1:52 STURGIS CORNER DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-5617
Practice Address - Country:US
Practice Address - Phone:319-343-1696
Practice Address - Fax:319-359-4123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1212512Medicaid