Individual
KIMBERLY D VAN WYNGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
17333 LA GRANGE RD STE 220, TINLEY PARK, IL 60487-7510
(708) 226-2870
(708) 226-2390
Mailing address
17333 LA GRANGE RD STE 220, TINLEY PARK, IL 60487-7510
(708) 226-2870
(708) 226-2390
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209011021
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F300116195
LOCALITY 16
IL
01
—
F300116196
LOCALITY 15
IL
01
—
P01451822
RRMC
IL
Enumeration date
12/02/2013
Last updated
03/03/2026
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