Provider Demographics
NPI:1801322326
Name:HYRC, KATHLEEN MARIA (APN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIA
Last Name:HYRC
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 N NORTHWEST HWY
Mailing Address - Street 2:#301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2777
Mailing Address - Country:US
Mailing Address - Phone:847-989-5809
Mailing Address - Fax:
Practice Address - Street 1:5965 N NORTHWEST HWY
Practice Address - Street 2:#301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2777
Practice Address - Country:US
Practice Address - Phone:847-989-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015205363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily