Provider Demographics
NPI:1942478441
Name:DAREY, KIMBERLEY M (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:M
Last Name:DAREY
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 1:172 SCHILLER
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2885
Mailing Address - Country:US
Mailing Address - Phone:630-941-2606
Mailing Address - Fax:630-758-8481
Practice Address - Street 1:1200 S. YORK RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-941-2606
Practice Address - Fax:630-758-8481
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-120053207V00000X
IL036120053207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology