MEDICARE: KIMBERLEY A HART NP

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	363L00000X	Nurse Practitioner	209004273	IL

General Provider Information

NPI Number	:	1629065099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLEY A HART NP

Provider Business Mailing Address
First Line	:	25070 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-0001
Country	:	US
Telephone Number	:	847-585-7000
Fax Number	:	847-240-0622

Provider Business Practice Location Address
First Line	:	880 W CENTRAL RD
Second Line	:	SUITE 8200
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2355
Country	:	US
Telephone Number	:	847-259-4482
Fax Number	:	847-259-6406

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	10/10/2013

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Directions to “ KIMBERLEY A HART NP” Practice Location

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