Healthcare Provider Details

I. General information

NPI: 1447481841
Provider Name (Legal Business Name): AMY M. KUHL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2009
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 W OGDEN AVE
CHICAGO IL
60623-2460
US

IV. Provider business mailing address

3860 W OGDEN AVE
CHICAGO IL
60623-2460
US

V. Phone/Fax

Practice location:
  • Phone: 872-588-3000
  • Fax: 872-588-3021
Mailing address:
  • Phone: 872-588-3000
  • Fax: 872-588-3021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number209007727
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.336476
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: