Provider Demographics
NPI:1588322291
Name:KESTER, ELIZABETH CARMEN (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CARMEN
Last Name:KESTER
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2536
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:5914 WOLFPEN PLEASANT HILL RD STE E
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-3078
Practice Address - Country:US
Practice Address - Phone:513-831-7503
Practice Address - Fax:513-831-7923
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007270363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant