Healthcare Provider Details

I. General information

NPI: 1154023281
Provider Name (Legal Business Name): DR. KIRSTEN MCAULIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. KIRSTEN KOCHAN

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE # 6098
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

180 HARVESTER DR STE 110
BURR RIDGE IL
60527-6686
US

V. Phone/Fax

Practice location:
  • Phone: 855-702-8222
  • Fax:
Mailing address:
  • Phone: 773-702-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.081653
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036.178739
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: