Provider Demographics
NPI:1811070014
Name:COUNTY OF KENDALL
Entity type:Organization
Organization Name:COUNTY OF KENDALL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PUBLIC HLTH ADMI
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMAAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKARS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-553-9100
Mailing Address - Street 1:811 W JOHN ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9249
Mailing Address - Country:US
Mailing Address - Phone:630-553-9100
Mailing Address - Fax:630-553-0167
Practice Address - Street 1:811 W JOHN ST
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560
Practice Address - Country:US
Practice Address - Phone:630-553-9100
Practice Address - Fax:630-553-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-0282-0002-A251K00000X
IL261QM0801X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251K00000XAgenciesPublic Health or Welfare
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)