Provider Demographics
NPI:1942676945
Name:KAREFIRST IOWA PC
Entity Type:Organization
Organization Name:KAREFIRST IOWA PC
Other - Org Name:KAREFIRST IOWA, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, APN, MSN
Authorized Official - Phone:773-552-1243
Mailing Address - Street 1:4711 GOLF RD
Mailing Address - Street 2:STE 1250
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1224
Mailing Address - Country:US
Mailing Address - Phone:847-235-6130
Mailing Address - Fax:847-235-6135
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:STE 1250
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1224
Practice Address - Country:US
Practice Address - Phone:847-235-6130
Practice Address - Fax:847-235-6135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty