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NPI Code Detail

MEDICARE: PENINAH KAMAU

MEDICARE:   PENINAH  KAMAU
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
1363LP2300XPrimary Care Nurse Practitioner209030425IL

General Provider Information

NPI Number : 1407680317
Entity Type Code : Individual
Provider Name (Legal Business Name) : PENINAH KAMAU
Provider Business Mailing Address
First Line : 1032 W SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1537
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1032 W SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1537
Country : US
Telephone Number : 773-274-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2024
Last Update Date : 09/02/2024

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Directions to “ PENINAH KAMAU ” Practice Location

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