Provider Demographics
NPI:1790146405
Name:LEFENS, KATHLEEN A (APN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:LEFENS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 PFINGSTEN RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1340
Mailing Address - Country:US
Mailing Address - Phone:847-503-3000
Mailing Address - Fax:
Practice Address - Street 1:2180 PFINGSTEN RD STE 3000
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1340
Practice Address - Country:US
Practice Address - Phone:847-503-3000
Practice Address - Fax:847-503-3500
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013995363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner