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General NPI Number Information
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NPI Number | 1124842992
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Entity Type | Organization
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Legal Business Name | KRISTINE KITCHENER
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1000 ESSINGTON RD
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City | JOLIET
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State | IL
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Zip | 60435-2841
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Country | US
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Telephone | 815-281-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 RIVER BEND LN
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City | PLAINFIELD
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State | IL
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Zip | 60586-6695
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Country | US
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Telephone | 815-955-8813
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KRISTINE L KITCHENER
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Credential |
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Telephone | 815-955-8813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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