Provider Demographics
NPI:1891912176
Name:KIESER, HILLARY BROWN (APN, CNM)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:BROWN
Last Name:KIESER
Suffix:
Gender:F
Credentials:APN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 THATCHER AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-2028
Mailing Address - Country:US
Mailing Address - Phone:708-228-6065
Mailing Address - Fax:
Practice Address - Street 1:1024 NORTH BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1169
Practice Address - Country:US
Practice Address - Phone:708-228-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000936367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife