Provider Demographics
NPI:1356433445
Name:HARMON, KATHLEEN JOHNSON (APRN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JOHNSON
Last Name:HARMON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:820 S WOOD ST # MC808
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:708-267-1082
Mailing Address - Fax:312-996-4238
Practice Address - Street 1:1801 WEST TAYLOR STREET
Practice Address - Street 2:CENTER FOR WOMEN'S HEALTH MC 650
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4795
Practice Address - Country:US
Practice Address - Phone:312-413-7500
Practice Address - Fax:312-413-3856
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000717367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife