Provider Demographics
NPI:1467296095
Name:SIMKOWSKI, KELLY (CD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:SIMKOWSKI
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2325
Mailing Address - Country:US
Mailing Address - Phone:708-420-0535
Mailing Address - Fax:
Practice Address - Street 1:330 N RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2325
Practice Address - Country:US
Practice Address - Phone:312-420-0535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula