KIMBERLY MIDDLETON (NPI# 1619944857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619944857 |
| Entity Type | Individual |
| Full Name | KIMBERLY MIDDLETON |
| Credential | M.D. |
| Practice Address |
17859 80th Ave Tinley Park IL 60477-5023 |
| Mailing Address |
2001 Butterfield Rd Ste 300 Downers Grove IL 60515-1069 |
| Practice Telephone | 7087099600 |
| Practice Fax Number | 7087564026 |
| Mailing Telephone | 6307252700 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2020-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | S4192 | TX | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
036103921 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CHAMPUS-CHAMPUS | KM086980 | 01 | |
| COMMERCIAL-COMMERCIAL NUMBER | KM086980 | 01 | |
| MI | 484049210 | 05 | |
| BLUE CROSS-BLUE CROSS | 080H262390 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154864742 | Kimberly Elaine Middleton | Nurse Practitioner | 4211 Joe Ramsey Blvd E Ste 105, Greenville, TX 75401 | 2016-11-30 |
| 1235532516 | Kimberly Middleton | Behavioral Analyst | 4158 W Us Highway 90 Ste 101, Lake City, FL 32055-4883 | 2014-10-01 |
| 1114485125 | Kimberly Dumont Middleton | Physical Therapist | 10700 Charter Dr Ste 205, Columbia, MD 21044-3687 | 2019-03-08 |
| 1013414051 | Kimberly Middleton | Registered Nurse | 1203 Maple St, Greensboro, NC 27405-6910 | 2018-04-06 |
| 1376782268 | Kimberly Middleton | Physical Therapist | 3825 Highway 80 E, Pearl, MS 39208-4232 | 2009-02-17 |
| Street Address |
17859 80TH AVE |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60477-5023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093028680 | St James Hospital United States Catholic Conference | Family Medicine | 17859 80th Ave, Tinley Park, IL 60477-5023 | 2010-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522366 | Joshua Gruenke | Physical Therapist | 17129 S. Harlem Avenue, Tinley Park, IL 60477 | 2020-09-14 |
| 1881229656 | Sherrie Lynn Tsang | Massage Therapist | 7925 West 171st Street, Tinley Park, IL 60477 | 2020-03-11 |
| 1437782117 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 17129 S Harlem Ave. Ste B3, Tinley Park, IL 60477 | 2020-02-20 |
| 1356998561 | Rasa Vaskeviciute | Physical Therapist | 17129 So Harlem, Tinley Park, IL 60477 | 2019-08-22 |
| 1538728258 | Michelle Anne Wisen | Physical Therapy Assistant | 17129 South Harlem, Suite B3, Tinley Park, IL 60477 | 2019-06-06 |
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1316445794 | Yvonne Tran | Physical Therapist | 17129 S Harlem Ave, Tinley Park, IL 60477 | 2018-01-31 |
| 1326574591 | Nicholas Barker | Chronic Disease Hospital | 7859 Joliet Drive North, Tinley Park, IL 60477 | 2017-05-10 |
| 1982063632 | Nicole Kristine Demarco | Specialist/Technologist | 16317 Clark Ln, Tinley Park, IL 60477 | 2016-02-22 |
| 1376900571 | Ucp Seguin Greater Chicago | Foster Care Agency | 7550 W. 183rd, Tinley Park, IL 60477 | 2016-01-20 |
| Find all providers in zip 60477 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1659915171 | Amanda Marie Wilderman | Family Medicine | 1268 Cole Place Rd, Chester, IL 62233-2054 | 2019-10-29 |
| 1699277038 | Eileen A Solis | Family Medicine | 1795 Grandstand Pl Ste 2, Elgin, IL 60123-4980 | 2018-03-01 |
| 1841703584 | Home Physicians of Illinois LLC | Family Medicine | 10027 Frontage Rd, Skokie, IL 60077-1033 | 2017-11-15 |
| 1770953986 | Mrs Integrative Medicine LLC | Family Medicine | 3s630 Glen Dr S, Warrenville, IL 60555-3506 | 2015-09-30 |
| 1447666318 | M & F Medical Services, Ltd | Family Medicine | 5642 N Christiana Ave, Chicago, IL 60659-4555 | 2014-07-10 |
| 1457767774 | Rambha Radhakrishnan | Family Medicine | 2645 W Peterson Ave, Chicago, IL 60659-4017 | 2014-07-08 |
| 1851733133 | Pyramids Advisors, Inc. | Family Medicine | 6427 Dempster St, Morton Grove, IL 60053-2604 | 2013-07-26 |
| 1558707075 | Jean M. Pouget | Family Medicine | 175 Northgate Rd, Riverside, Riverside, IL 60546-1683 | 2013-05-13 |
| 1629411806 | Rahman Fazil Mohammed Abdul | Family Medicine | 9011 W Ballard Rd Apt 1a, Des Plaines, IL 60016-4987 | 2013-04-08 |
| Find all providers with the same taxonomy | ||||
| City | TINLEY PARK |
| Zip Code | 60477 |
Please comment or provide details below to improve the information on KIMBERLY MIDDLETON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.