Provider Demographics
NPI:1295217651
Name:THIES, KAIRSTEN (DNP, APRN-CFM, CEFM)
Entity type:Individual
Prefix:DR
First Name:KAIRSTEN
Middle Name:
Last Name:THIES
Suffix:
Gender:F
Credentials:DNP, APRN-CFM, CEFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N LASALLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610
Mailing Address - Country:US
Mailing Address - Phone:312-592-2214
Mailing Address - Fax:
Practice Address - Street 1:1200 N LASALLE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610
Practice Address - Country:US
Practice Address - Phone:312-592-2214
Practice Address - Fax:312-266-8797
Is Sole Proprietor?:No
Enumeration Date:2018-09-02
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.402404163WX0003X
IL209.017971367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife