Individual
KATRINA WIEDENFELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CPNP-PC
Contact information
Practice address
70 MEADOWVIEW CTR STE 300, KANKAKEE, IL 60901-2062
(815) 802-0022
(815) 802-0011
Mailing address
1108 KENSINGTON ST, SHOREWOOD, IL 60404-9407
(815) 546-6186
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
209.033009
IL
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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