Healthcare Provider Details

I. General information

NPI: 1013603885
Provider Name (Legal Business Name): KAREFIRST OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24579 BROADWAY AVE
OAKWOOD OH
44146-6338
US

IV. Provider business mailing address

6348 N MILWAUKEE AVE STE 390
CHICAGO IL
60646-3728
US

V. Phone/Fax

Practice location:
  • Phone: 440-439-7976
  • Fax: 847-386-5196
Mailing address:
  • Phone: 847-235-6130
  • Fax: 847-235-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY WILSON
Title or Position: PRESIDENT
Credential: RN, MSN, APN
Phone: 847-235-6130