Individual
MS. KATHRYN R PENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
10350 HALIGUS RD STE 200D, HUNTLEY, IL 60142-9545
(847) 802-7280
(847) 802-7275
Mailing address
10400 HALIGUS RD, HUNTLEY, IL 60142-9553
(224) 654-0040
(224) 654-0027
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209010782
IL
363LF0000X
Family Nurse Practitioner
209.010782
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400124968
MEDICARE PTAN
IL
Enumeration date
10/16/2013
Last updated
07/30/2024
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