Kenneth Lyle Holland, - Nurse Practitioner in Broadview, IL

Kenneth Lyle Holland, is a Nurse Practitioner - Psychiatric/mental Health based in Broadview, Illinois. Kenneth Lyle Holland is licensed to practice in Illinois (license number 209029961) and his current practice location is 2325 S 18th Ave, Broadview, Illinois. He can be reached at his office (for appointments etc.) via phone at (773) 706-5802.

NPI number for Kenneth Lyle Holland is 1679327266 and his current mailing address is 2325 S 18th Ave, Broadview, Illinois. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679327266.

Contact Information

Kenneth Lyle Holland,
2325 S 18th Ave,
Broadview, IL 60155-3927
(773) 706-5802
Not Available

Map and Direction




Provider's Profile

Full NameKenneth Lyle Holland
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location2325 S 18th Ave, Broadview, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1679327266
  • Provider Enumeration Date: 04/11/2024
  • Last Update Date: 07/09/2024

Medical Identifiers

Medical identifiers for Kenneth Lyle Holland such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679327266NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 209029961 (Illinois)Primary
163WP0807XRegistered Nurse - Psychiatric/mental Health, Child & Adolescent 041448188 (Illinois)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Lyle Holland is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kenneth Lyle Holland,
2325 S 18th Ave,
Broadview, IL 60155-3927

Ph: () -
Kenneth Lyle Holland,
2325 S 18th Ave,
Broadview, IL 60155-3927

Ph: (773) 706-5802

Reviews and Comments


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