Individual
KIMBERLY SOUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-1363
Mailing address
526 OLD HICKORY RD, NEW LENOX, IL 60451-1651
(815) 693-5995
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.007767
IL
Other
Enumeration date
10/16/2009
Last updated
11/30/2021
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