Healthcare Provider Details

I. General information

NPI: 1346107034
Provider Name (Legal Business Name): MCKAI VANN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23760 W 127TH ST APT 112
PLAINFIELD IL
60585-9724
US

IV. Provider business mailing address

23760 W 127TH ST APT 112
PLAINFIELD IL
60585-9724
US

V. Phone/Fax

Practice location:
  • Phone: 630-870-6720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.118643
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: