Individual
DR. KIMBERLY J. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
(815) 740-7050
Mailing address
9234 CLOISTER CT, FRANKFORT, IL 60423-3155
(815) 534-5502
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
0101840517
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
036117711
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117711
—
IL
Enumeration date
04/08/2006
Last updated
08/14/2013
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