MEDICARE: KIMBERLY LAFAYE MCCLENDON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider		IL

General Provider Information

NPI Number	:	1093662454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY LAFAYE MCCLENDON

Provider Business Mailing Address
First Line	:	2425 FLOSSMOOR RD
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-1517
Country	:	US
Telephone Number	:	312-569-8807
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 FLOSSMOOR RD
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-1517
Country	:	US
Telephone Number	:	312-569-8807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “ KIMBERLY LAFAYE MCCLENDON ” Practice Location

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