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General NPI Number Information
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NPI Number | 1548170053
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Entity Type | Individual
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Provider Name | KIMBERLY ANGLIN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 800 AUSTIN ST STE 360
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City | EVANSTON
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State | IL
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Zip | 60202-3454
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Country | US
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Telephone | 847-316-2635
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Fax |
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Provider Business Mailing Address
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Address Line | 420 W SURF ST APT 504
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City | CHICAGO
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State | IL
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Zip | 60657-6120
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Country | US
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Telephone | 419-602-1255
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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 | 209036553
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License Number State | IL
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