Epmg Of Illinois LLC

Emergency Medicine in Kankakee, IL. Organization (NPI-2).

NPI number1528098902

StatusActive

Last updated in NPPESJul 31, 2020

Details

NPI: 1528098902
Entity type: Organization (NPI-2)
Legal business name: Epmg Of Illinois LLC
Organization subpart: No
Enumeration date: Jul 3, 2006
Certification date: Jul 31, 2020
Last updated: Jul 31, 2020

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207P00000X	Emergency Medicine	–	–	Yes

Practice location

350 N Wall St
Kankakee, IL 60901-2901

Phone 469-401-2386

Mailing address

5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563

Phone 973-251-1132

Authorized official

Mike Mikhail
Officer
9732511132

Is something wrong?

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Other Emergency Medicine Physician providers in Kankakee, IL

All 19 Emergency Medicine Physician providers in Kankakee · All 851 providers in Kankakee

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