Provider Demographics
NPI:1881886687
Name:KAMMER, FREDDRIKA L (APN)
Entity type:Individual
Prefix:
First Name:FREDDRIKA
Middle Name:L
Last Name:KAMMER
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 1:2800 N LAKE SHORE DR
Mailing Address - Street 2:3916
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6232
Mailing Address - Country:US
Mailing Address - Phone:847-337-1396
Mailing Address - Fax:888-845-9162
Practice Address - Street 1:514 TEELA LN
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1230
Practice Address - Country:US
Practice Address - Phone:847-337-1396
Practice Address - Fax:888-845-9162
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health