Healthcare Provider Details

I. General information

NPI: 1992047971
Provider Name (Legal Business Name): KIMBERLY CHRISTINE KIBBONS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N YORK RD
HINSDALE IL
60521-2950
US

IV. Provider business mailing address

355 E ERIE ST STE 3
CHICAGO IL
60611-3167
US

V. Phone/Fax

Practice location:
  • Phone: 630-590-5751
  • Fax:
Mailing address:
  • Phone: 312-238-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.010230
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.322163
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: