Individual
KAYLA CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8711 W CERMAK RD, NORTH RIVERSIDE, IL 60546-1166
(708) 442-7979
(708) 442-8574
Mailing address
10551 WINDSOR DR, WESTCHESTER, IL 60154-5328
(925) 949-6691
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
783207
CA
363LF0000X
Family Nurse Practitioner
Primary
209021842
IL
363LF0000X
Family Nurse Practitioner
95005582
CA
Other
Enumeration date
09/18/2015
Last updated
09/22/2020
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