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General NPI Number Information
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NPI Number | 1043648744
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Entity Type | Individual
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Provider Name | KATHRYN R PENNELL APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 10350 HALIGUS RD STE 200D
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City | HUNTLEY
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State | IL
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Zip | 60142-9545
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Country | US
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Telephone | 847-802-7280
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Fax | 847-802-7275
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Provider Business Mailing Address
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Address Line | 10400 HALIGUS RD
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City | HUNTLEY
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State | IL
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Zip | 60142-9553
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Country | US
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Telephone | 224-654-0040
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Fax | 224-654-0027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.010782
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209010782
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License Number State | IL
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