| NPI | 1154875011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE M KIMBALL Family Nurse Practitioner 708-369-2241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011296) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |