Provider Demographics
NPI:1093313249
Name:RESCHKE, KIMBERLY (BSN RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:RESCHKE
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5835
Mailing Address - Country:US
Mailing Address - Phone:312-860-8023
Mailing Address - Fax:
Practice Address - Street 1:711 N STRATFORD RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5835
Practice Address - Country:US
Practice Address - Phone:312-860-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.413065163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical