Basic Information
Provider Information
NPI: 1558312918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KIRKEGAARD
FirstName: MARGARET
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 135 N OAK ST
Address2:  
City: HINSDALE
State: IL
PostalCode: 605213860
CountryCode: US
TelephoneNumber: 6308566865
FaxNumber: 6308566813
Practice Location
Address1: 135 N OAK ST
Address2:  
City: HINSDALE
State: IL
PostalCode: 605213860
CountryCode: US
TelephoneNumber: 6308568900
FaxNumber: 6308568923
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 03/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X36083092ILY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
03608309205IL MEDICAID


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