Provider Demographics
NPI:1093843542
Name:ELWART, KRISTIN J (APN)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:J
Last Name:ELWART
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Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:840 S WOOD ST
Mailing Address - Street 2:MC 856
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-6605
Mailing Address - Fax:312-413-3373
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-996-6605
Practice Address - Fax:312-413-3373
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL277000731363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics