Provider Demographics
NPI:1154321339
Name:LIBERTY, KRISTINE NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:NOEL
Last Name:LIBERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 W 127TH ST
Mailing Address - Street 2:BUILDING B SUITE 345
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-9502
Mailing Address - Country:US
Mailing Address - Phone:815-609-5437
Mailing Address - Fax:815-609-8111
Practice Address - Street 1:24600 W 127TH ST
Practice Address - Street 2:BUILDING B SUITE 345
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9502
Practice Address - Country:US
Practice Address - Phone:815-609-5437
Practice Address - Fax:815-609-8111
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics