Provider Demographics
NPI:1154184216
Name:IIIKINGZ LLC
Entity type:Organization
Organization Name:IIIKINGZ LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:L LUPE
Authorized Official - Middle Name:IVES
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-808-8809
Mailing Address - Street 1:400 CHESTERFIELD CTR STE 400
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4800
Mailing Address - Country:US
Mailing Address - Phone:630-808-8809
Mailing Address - Fax:
Practice Address - Street 1:400 CHESTERFIELD CTR STE 400
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4800
Practice Address - Country:US
Practice Address - Phone:630-808-8809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IIIKINGZ LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-01
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty