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General NPI Number Information
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NPI Number | 1144953209
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Entity Type | Organization
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Legal Business Name | NEST PEDIATRICS PC
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 473 W ARMY TRAIL RD STE 103
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-529-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 473 W ARMY TRAIL RD STE 103
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTEN KLOCKER
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Credential | APRN
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Telephone | 630-529-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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