MEDICARE: KIMBERLY NICOLE CANFIELD MD

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	208000000X	Pediatrics Physician	036130291	IL

General Provider Information

NPI Number	:	1174771836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY NICOLE CANFIELD MD

Provider Business Mailing Address
First Line	:	111 W RAND RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:	612-581-6076
Fax Number	:	773-313-8167

Provider Business Practice Location Address
First Line	:	111 W RAND RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3142
Country	:	US
Telephone Number	:	612-581-6076
Fax Number	:	773-313-8167

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

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	05/29/2026

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Directions to “ KIMBERLY NICOLE CANFIELD MD” Practice Location

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