Individual
KIM TILLEMANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1020 WEST BROADWAY, UMP BROADWAY FAMILY MEDICINE URGENT CARE, MINNEAPOLIS, MN 55411
(612) 302-8275
Mailing address
420 DELAWARE STREET SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 302-8275
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47806
MN
207V00000X
Obstetrics & Gynecology Physician
Primary
47806
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0596106
—
IA
05
—
43523000
—
WI
01
—
66-08643
MEDICA
MN
01
—
HP54459
HEALTHPARTNERS
MN
Enumeration date
10/11/2006
Last updated
06/03/2024
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