Provider Demographics
NPI:1174342844
Name:SIMS, KIARRA (NP)
Entity type:Individual
Prefix:
First Name:KIARRA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4244 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-2004
Mailing Address - Country:US
Mailing Address - Phone:708-446-4432
Mailing Address - Fax:
Practice Address - Street 1:360 W BUTTERFIELD RD STE 270
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5098
Practice Address - Country:US
Practice Address - Phone:630-523-9161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.030746363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care