Individual
KIMBERLY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 CHEKER SQ, HAZEL CREST, IL 60429-1442
(708) 647-3397
Mailing address
17746 OAK PARK AVE, TINLEY PARK, IL 60477-3936
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041292538
IL
Other
Enumeration date
12/07/2011
Last updated
10/24/2016
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