Provider Demographics
NPI:1013603885
Name:KAREFIRST OHIO
Entity Type:Organization
Organization Name:KAREFIRST OHIO
Other - Org Name:
Other - Org Type:
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, MSN, APN
Authorized Official - Phone:847-235-6130
Mailing Address - Street 1:4711 GOLF RD STE 1250
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1232
Mailing Address - Country:US
Mailing Address - Phone:847-235-6130
Mailing Address - Fax:847-386-5196
Practice Address - Street 1:24579 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:44146-6338
Practice Address - Country:US
Practice Address - Phone:440-439-7976
Practice Address - Fax:847-386-5196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty