MRS. KIMBERLY DUBACK (NPI# 1992196380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992196380 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY DUBACK |
| Credential | APN |
| Practice Address |
4440 W 95th St Oak Lawn IL 60453-2600 |
| Mailing Address |
766 Lambeth Ln New Lenox IL 60451-9639 |
| Practice Telephone | 7086844207 |
| Mailing Telephone | 7088467183 |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2015-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
209012326 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4440 W 95TH ST |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805666 | Kenneth S. Toth | Anesthesiology | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2005-07-15 |
| 1821697392 | Marissa Vavra | Occupational Therapist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-10-25 |
| 1215535638 | Jarrod Siek Georgacakis | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-10-16 |
| 1396350708 | Crystal Oehmen | Radiology | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-09-11 |
| 1255943999 | Kristen Michele Hill | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-08-22 |
| 1033735295 | Thomas Panicucci | Registered Nurse | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-23 |
| 1538785407 | Amanda Thompson | Nurse Practitioner | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-17 |
| 1508481250 | Amy Marie Fader | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-06-09 |
| 1528680139 | Nader Hamzeh Darwish | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-05-18 |
| 1003438920 | Anna Manilla | Speech-Language Pathologist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2020-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
| Find all providers in zip 60453 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639473549 | Kimberly Wittmayer | Clinical Nurse Specialist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2011-01-06 |
| 1386830495 | Katherine A Wittle | Clinical Nurse Specialist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2007-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962666123 | Sharon Marie Coyer | Clinical Nurse Specialist | 534 Brownstone Dr, St Charles, IL 60174-2807 | 2008-07-16 |
| 1760646962 | Thelma P. Reed | Clinical Nurse Specialist | 326 .west 64th St., Suite 412, Chicago, IL 60621-1334 | 2008-07-16 |
| 1871711283 | Jeannine Marie Cheatham | Clinical Nurse Specialist | 5841 S Maryland Ave # Mc4064, Room C146, Chicago, IL 60637-1447 | 2007-04-23 |
| 1578649372 | Renee C.b. Manworren | Clinical Nurse Specialist | 225 E. Chicago Avenue, Box 47, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611-2991 | 2006-10-27 |
| 1679594014 | Therese Nancy Coha | Clinical Nurse Specialist | 2300 N Childrens Plz # 63, Chicago, IL 60614-3363 | 2006-07-21 |
| 1164908992 | Megan Hughes | Clinical Nurse Specialist | 1775 W Dempster St, Park Ridge, IL 60068-1143 | 2018-07-16 |
| 1508381161 | Nicholette M Andrews | Clinical Nurse Specialist | 355 E Erie St, Chicago, IL 60611-3167 | 2017-08-04 |
| 1083062285 | Heather A Boore | Clinical Nurse Specialist | 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 | 2016-05-27 |
| 1790139384 | Jenna Ford | Clinical Nurse Specialist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2016-04-20 |
| 1043684533 | Gabriel Campos | Clinical Nurse Specialist | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2015-11-20 |
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| 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.