Miss Kimberly Michelle Waller, LPN - Licensed Practical Nurse in Chicago, IL

Miss Kimberly Michelle Waller, LPN is a Licensed Practical Nurse based in Chicago, Illinois. Miss Kimberly Michelle Waller is licensed to practice in Illinois (license number 043120655) and her current practice location is 4707 N Malden St, Apt 303, Chicago, Illinois. She can be reached at her office (for appointments etc.) via phone at (312) 975-3312.

NPI number for Miss Kimberly Michelle Waller is 1407298698 and her current mailing address is 4707 N Malden St, Apt 303, Chicago, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407298698.

Contact Information

Miss Kimberly Michelle Waller, LPN
4707 N Malden St, Apt 303,
Chicago, IL 60640-6917
(312) 975-3312
Not Available

Map and Direction




Provider's Profile

Full NameMiss Kimberly Michelle Waller
GenderFemale
SpecialityLicensed Practical Nurse
Location4707 N Malden St, Chicago, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1407298698
  • Provider Enumeration Date: 07/29/2013
  • Last Update Date: 07/21/2016

Medical Identifiers

Medical identifiers for Miss Kimberly Michelle Waller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407298698NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164W00000XLicensed Practical Nurse 043120655 (Illinois)Primary
164W00000XLicensed Practical Nurse 128873 (Ohio)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. Miss Kimberly Michelle Waller 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
Miss Kimberly Michelle Waller, LPN
4707 N Malden St, Apt 303,
Chicago, IL 60640-6917

Ph: (312) 975-3312
Miss Kimberly Michelle Waller, LPN
4707 N Malden St, Apt 303,
Chicago, IL 60640-6917

Ph: (312) 975-3312

Reviews and Comments


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