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General NPI Number Information
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NPI Number | 1841729985
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Entity Type | Individual
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Provider Name | KIM ANDERSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2017
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 2845 N SHERIDAN ROAD SUITE 907
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-295-0707
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Fax | 872-243-2843
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Provider Business Mailing Address
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Address Line | 2845 N SHERIDAN ROAD SUITE 907
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-295-0707
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Fax | 872-243-2843
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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 | 832075
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28194001A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209017385
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277001265
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License Number State | IL
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