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General NPI Number Information
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NPI Number | 1619578523
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Entity Type | Individual
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Provider Name | KAITLIN LAWSON KALNITZ APN
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Gender | Female
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 745 MCCLINTOCK DR STE 360
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City | BURR RIDGE
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State | IL
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Zip | 60527-0875
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Country | US
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Telephone | 630-832-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 BERKLEY CT
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City | DEERFIELD
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State | IL
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Zip | 60015-2031
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Country | US
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Telephone | 630-638-1529
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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 | 209021288
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License Number State | IL
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