Healthcare Provider Details

I. General information

NPI: 1568374312
Provider Name (Legal Business Name): KIMBERLY LYNN BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 N RAVENSWOOD AVE UNIT 2
CHICAGO IL
60613-2193
US

IV. Provider business mailing address

8905 S YATES BLVD
CHICAGO IL
60617-3864
US

V. Phone/Fax

Practice location:
  • Phone: 773-572-5400
  • Fax: 773-432-6538
Mailing address:
  • Phone: 312-593-5211
  • Fax: 773-432-6538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209036555
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: