Healthcare Provider Details

I. General information

NPI: 1578475174
Provider Name (Legal Business Name): SKREEN PRO SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W WILSON DR
KANKAKEE IL
60901-2255
US

IV. Provider business mailing address

830 W WILSON DR
KANKAKEE IL
60901-2255
US

V. Phone/Fax

Practice location:
  • Phone: 779-221-2396
  • Fax: 779-201-6530
Mailing address:
  • Phone: 779-221-2396
  • Fax: 779-201-6530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: KIM DAVIS
Title or Position: CEO
Credential:
Phone: 779-221-2396