Healthcare Provider Details

I. General information

NPI: 1114883741
Provider Name (Legal Business Name): KIARA HINKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N GREENLEAF ST STE B
GURNEE IL
60031-3326
US

IV. Provider business mailing address

18197 W BANBURY DR
GURNEE IL
60031-4580
US

V. Phone/Fax

Practice location:
  • Phone: 847-604-0955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-354620
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: