Individual
KIRSTEN HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-6120
Mailing address
5309 N BERNARD ST, CHICAGO, IL 60625-4703
(773) 633-6694
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209028110
IL
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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