Provider Demographics
NPI:1891936324
Name:HKM ENTERPRISES, LLC.
Entity Type:Organization
Organization Name:HKM ENTERPRISES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-220-2477
Mailing Address - Street 1:6640 S KIMBARK AVE
Mailing Address - Street 2:#1-N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-4683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6640 S KIMBARK AVE
Practice Address - Street 2:#1-N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-4683
Practice Address - Country:US
Practice Address - Phone:773-220-2477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109936Medicaid