OrganizationActive
Med Peds Associates
NPI 1649353970 · Non-Pharmacy Dispensing Site · Kankakee, IL
Provider details
- NPI number
- 1649353970
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Direndia Shackelford, Managed Care Specialist(800) 654-0889
- License
- 036074737 (IL)
Specialties & taxonomies
Suppliers
Practice location
375 N Wall St Ste P520
Kankakee, IL 60901-3493
Phone: (815) 933-0194
Fax: (815) 933-1444
Approximate (ZIP-level) locationGet directions
Mailing address
375 N Wall St Ste P520
Kankakee, IL 60901-3493
Other names (DBA / former)
- Doing business as
- Med Peds Associates
Registry dates
- Enumerated
- 2006-10-23
- Last updated
- 2008-09-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.