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NPI Code Detail

MEDICARE: DR. KIMBERLY ARETHA TONEY M.D

MEDICARE: DR. KIMBERLY ARETHA TONEY M.D
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
1207Q00000XFamily Medicine Physician036103429IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104876432
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY ARETHA TONEY M.D
Provider Business Mailing Address
First Line : 9308 S VERNON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-7453
Country : US
Telephone Number : 773-278-5126
Fax Number : 773-409-1902
Provider Business Practice Location Address
First Line : 7731 S HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60620-2412
Country : US
Telephone Number : 773-962-3705
Fax Number : 773-962-3703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 11/05/2010

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