Provider Demographics
NPI:1841519691
Name:KANKAKEE URGENT CARE
Entity type:Organization
Organization Name:KANKAKEE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLATUNJI
Authorized Official - Middle Name:R
Authorized Official - Last Name:AKINTILO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-614-3700
Mailing Address - Street 1:187 S SCHUYLER AVE
Mailing Address - Street 2:SUITE 344
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3831
Mailing Address - Country:US
Mailing Address - Phone:815-614-3700
Mailing Address - Fax:
Practice Address - Street 1:187 S SCHUYLER AVE
Practice Address - Street 2:SUITE 344
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3831
Practice Address - Country:US
Practice Address - Phone:815-614-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty