MEDICARE: KATHLEEN MARIE MONSALUD APRN

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	209.034707	IL

General Provider Information

NPI Number	:	1891646899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MARIE MONSALUD APRN

Provider Business Mailing Address
First Line	:	15060 W SAGEBRUSH LN
Second Line	:
City	:	LOCKPORT
State	:	IL
Zip	:	60441-1350
Country	:	US
Telephone Number	:	630-677-8648
Fax Number	:

Provider Business Practice Location Address
First Line	:	7315 LEMONT RD
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-3807
Country	:	US
Telephone Number	:	630-677-8648
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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