Basic Information
| Provider Information | |||||||||
| NPI: | 1548743388 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | HEMALI | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 745 FLETCHER DR STE 202 | ||||||||
| Address2: | |||||||||
| City: | ELGIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601234749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478881300 | ||||||||
| FaxNumber: | 8478881341 | ||||||||
| Practice Location | |||||||||
| Address1: | 745 FLETCHER DR STE 202 | ||||||||
| Address2: | |||||||||
| City: | ELGIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601234749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478881300 | ||||||||
| FaxNumber: | 8478881341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2018 | ||||||||
| LastUpdateDate: | 09/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 209-017721 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.