Individual
KATHLEEN PROBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2319 OLD PLANK RD, CHESTER, IL 62233-1153
(618) 826-2388
(618) 826-3350
Mailing address
4084 REDCASTLE PL, SWANSEA, IL 62226-7853
(618) 239-6923
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
143113
MO
363LF0000X
Family Nurse Practitioner
Primary
209006709
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006709
MEDICAL LICENSE NUMBER
IL
Enumeration date
08/14/2007
Last updated
12/23/2019
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