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NPI Code Detail

MEDICARE: KGK & ASSOCIATES

MEDICARE: KGK & ASSOCIATES
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
1302F00000XExclusive Provider Organization046010348IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11932413697OTHERILNPI TYPE 1

General Provider Information

NPI Number : 1851758858
Entity Type Code : Organization
Provider Name (Legal Business Name) : KGK & ASSOCIATES
Provider Business Mailing Address
First Line : 24733 S POTAWATOMIE TRL
Second Line :
City : CHANNAHON
State : IL
Zip : 60410-8639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1521 ESSINGTON RD
Second Line :
City : JOLIET
State : IL
Zip : 60435-2879
Country : US
Telephone Number : 815-729-2002
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. ANN E KARKOWSKI
Credential : OD
Telephone Number : 815-238-1465
Provider Enumeration Date : 01/21/2016
Last Update Date : 01/21/2016

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Directions to “KGK & ASSOCIATES ” Practice Location

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