Provider Demographics
NPI:1982749750
Name:ROHAN, KIMBERLY ANN (APN)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANN
Last Name:ROHAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27555 DIEHL RD
Mailing Address - Street 2:ENTRANCE B
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3849
Mailing Address - Country:US
Mailing Address - Phone:630-646-3884
Mailing Address - Fax:630-548-0276
Practice Address - Street 1:120 SPALDING DR
Practice Address - Street 2:SUITE 111
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6766
Practice Address - Country:US
Practice Address - Phone:630-527-3788
Practice Address - Fax:630-646-6071
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-002147364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK39147Medicare PIN
ILK39148Medicare PIN
ILK45674Medicare PIN