Individual
KATHLEEN A MALINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2400 BIG TIMBER ROAD, ELGIN, IL 60124
(847) 697-0770
Mailing address
2400 BIG TIMBER RD, ELGIN, IL 60124-7835
(847) 697-0770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-393-633
IL
363L00000X
Nurse Practitioner
Primary
209016482
IL
363LF0000X
Family Nurse Practitioner
209016482
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-393-633
ILLINOIS BOARD OF NURSING
IL
Enumeration date
08/14/2017
Last updated
11/16/2020
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