Provider Demographics
NPI:1184916181
Name:WARDEN-THOMAS, KARIN ADINE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:ADINE
Last Name:WARDEN-THOMAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 W 117TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4752
Mailing Address - Country:US
Mailing Address - Phone:773-239-7475
Mailing Address - Fax:
Practice Address - Street 1:3535 BROADWAY
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46409-1316
Practice Address - Country:US
Practice Address - Phone:219-884-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008566363LF0000X
IN71003576A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily