Provider Demographics
NPI:1437447679
Name:HUGHES, KYLIE A (NP)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E OHIO ST
Mailing Address - Street 2:APT 1710
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3470
Mailing Address - Country:US
Mailing Address - Phone:312-206-9219
Mailing Address - Fax:708-684-7040
Practice Address - Street 1:4400 W 95TH ST
Practice Address - Street 2:POB 407
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2654
Practice Address - Country:US
Practice Address - Phone:708-684-7032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008902363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health