Individual
KRISTINA SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10604 SOUTHWEST HWY STE 101, CHICAGO RIDGE, IL 60415-2704
(708) 346-4065
(708) 423-5799
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020105
IL
Other
Enumeration date
10/15/2019
Last updated
08/07/2025
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