Kimballs Healthcare Consultants
Nurse Practitioner, Family in South Holland, IL. Organization (NPI-2).
NPI number1154875011
StatusActive
Last updated in NPPESAug 9, 2016
Details
- NPI
- 1154875011
- Entity type
- Organization (NPI-2)
- Legal business name
- Kimballs Healthcare Consultants
- Organization subpart
- No
- Enumeration date
- Aug 9, 2016
- Last updated
- Aug 9, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209.011296 | IL | Yes |
Practice location
430 E 162nd StSouth Holland, IL 60473-2258
Phone 708-369-2241
Mailing address
15933 Ellis AveSouth Holland, IL 60473-1740
Phone 708-369-2241
Authorized official
Jacqueline M Kimball
Family Nurse Practitioner
7083692241
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