MEDICARE: KIARA ANNE PERKINS

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	363LF0000X	Family Nurse Practitioner	209027886	IL

General Provider Information

NPI Number	:	1225726151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA ANNE PERKINS

Provider Business Mailing Address
First Line	:	6444 S WOODLAWN AVE APT 1N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-7344
Country	:	US
Telephone Number	:	773-317-5554
Fax Number	:

Provider Business Practice Location Address
First Line	:	244 E PERSHING RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-2222
Country	:	US
Telephone Number	:	773-317-5554
Fax Number	:

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

Provider Enumeration Date	:	04/27/2023
Last Update Date	:	02/20/2024

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Directions to “ KIARA ANNE PERKINS ” Practice Location

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