MEDICARE: TINOTENDA SAMSON KANGAYI JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		IL

General Provider Information

NPI Number	:	1023966413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINOTENDA SAMSON KANGAYI JR.

Provider Business Mailing Address
First Line	:	850 LINCOLN DR
Second Line	:
City	:	CARBONDALE
State	:	IL
Zip	:	62901-4307
Country	:	US
Telephone Number	:	618-453-2434
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 LINCOLN DR
Second Line	:
City	:	CARBONDALE
State	:	IL
Zip	:	62901-4307
Country	:	US
Telephone Number	:	618-453-2434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

Similar Medicare Providers

1144742230 — DR. ALAA MOHAMED AHMED MD
Practice Location Address:

2601 W MAIN ST
CARBONDALE, IL
62901-1031

Practice Phone: 618-549-5361
Practice Fax: 618-351-4878

1912855560 — DR. FATOUMATA SAIDOU HANGADOUMBO PHD, MPH, CHES
Practice Location Address:

1239 E MAIN ST
CARBONDALE, IL
62901-3175

Practice Phone: 618-457-5200
Practice Fax:

1699201384 — DR. EDGAR ANDRES BELLO MARTINEZ M.D.
Practice Location Address:

405 W JACKSON ST
CARBONDALE, IL
62901-1462

Practice Phone: 618-549-0721
Practice Fax:

1477400356 — AMAL SIENY LCSW
Practice Location Address:

704 S EMERALD LN
CARBONDALE, IL
62901-2146

Practice Phone: 571-733-4596
Practice Fax:

1912908906 — MISS SHERRY K JONES MD
Practice Location Address:

101 S WALL ST
CARBONDALE, IL
62901

Practice Phone: 618-519-9200
Practice Fax: 618-519-9404

1225065220 — DR. RAKESH CHANDRA MD
Practice Location Address:

1155 CEDAR CT
CARBONDALE, IL
62901-5333

Practice Phone: 618-490-1045
Practice Fax: 618-319-1279

Directions to “ TINOTENDA SAMSON KANGAYI JR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.