Healthcare Provider Details

I. General information

NPI: 1174771836
Provider Name (Legal Business Name): KIMBERLY NICOLE CANFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W RAND RD
ARLINGTON HEIGHTS IL
60004-3142
US

IV. Provider business mailing address

111 W RAND RD
ARLINGTON HEIGHTS IL
60004-3142
US

V. Phone/Fax

Practice location:
  • Phone: 612-581-6076
  • Fax: 773-313-8167
Mailing address:
  • Phone: 612-581-6076
  • Fax: 773-313-8167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036130291
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: