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General NPI Number Information
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NPI Number | 1144185885
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Entity Type | Organization
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Legal Business Name | EXPRESS MEDICAL LLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 11 S WHITE ST SUITE 104
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City | FRANKFORT
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State | IL
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Zip | 60423-4009
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Country | US
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Telephone | 877-363-3772
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Fax | 762-722-8386
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Provider Business Mailing Address
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Address Line | 11 S WHITE ST STE 104
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City | FRANKFORT
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State | IL
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Zip | 60423-4018
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Country | US
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Telephone | 877-363-3772
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Fax | 762-722-8386
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | COURTNEY B CANTRELL
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Credential |
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Telephone | 423-413-3832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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