Healthcare Provider Details

I. General information

NPI: 1053122374
Provider Name (Legal Business Name): KATHLEEN POSA-KEARNEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W HARRISON ST
CHICAGO IL
60612-3801
US

IV. Provider business mailing address

2516 JOHN BOURG DR
PLAINFIELD IL
60586-8227
US

V. Phone/Fax

Practice location:
  • Phone: 312-947-1131
  • Fax:
Mailing address:
  • Phone: 734-891-3477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number209.020434
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: