Provider Demographics
NPI:1841395753
Name:SORENSEN, KIRSTEN E (CNP, CDE)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:E
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:CNP, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST
Mailing Address - Street 2:17-250
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5975
Mailing Address - Country:US
Mailing Address - Phone:312-695-2561
Mailing Address - Fax:312-695-2543
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:17-250
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-2561
Practice Address - Fax:312-695-2543
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041339626363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner