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General NPI Number Information
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NPI Number | 1174072037
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Entity Type | Individual
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Provider Name | KIMBERLE CROSBY NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2016
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 301 MADISON ST
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City | JOLIET
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State | IL
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Zip | 60435-6549
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Country | US
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Telephone | 815-729-3294
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Fax | 630-718-2667
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Provider Business Mailing Address
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Address Line | PO BOX 713260
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City | CHICAGO
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State | IL
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Zip | 60677-1260
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Country | US
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Telephone | 630-469-9200
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-014732
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209014732
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License Number State | IL
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