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General NPI Number Information
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NPI Number | 1063249373
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Entity Type | Individual
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Provider Name | KYTORI TOLBERT MSN, APRN, FNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 2955 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2409
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Country | US
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Telephone | 708-423-2880
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Fax |
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Provider Business Mailing Address
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Address Line | 4817 W 83RD ST
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City | BURBANK
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State | IL
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Zip | 60459-2790
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Country | US
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Telephone | 773-941-9750
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Fax |
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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 | 209032089
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041468791
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License Number State | IL
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