Healthcare Provider Details

I. General information

NPI: 1275543167
Provider Name (Legal Business Name): PCP OF ESSINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 ESSINGTON RD SUITE 100
JOLIET IL
60435-2801
US

IV. Provider business mailing address

32 W NEBRASKA ST SUITE A
FRANKFORT IL
60423-1800
US

V. Phone/Fax

Practice location:
  • Phone: 815-464-5986
  • Fax: 815-806-8756
Mailing address:
  • Phone: 815-464-5986
  • Fax: 815-806-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JOSEPH A HINDO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 815-464-5986