Provider Demographics
NPI:1912626458
Name:WADMAN, KIMBERLY CARMEN (APN-CNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CARMEN
Last Name:WADMAN
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W. CENTRAL RD.
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIA
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2349
Mailing Address - Country:US
Mailing Address - Phone:847-570-2760
Mailing Address - Fax:847-570-2921
Practice Address - Street 1:800 W. CENTRAL RD.
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2349
Practice Address - Country:US
Practice Address - Phone:847-570-2760
Practice Address - Fax:847-570-2921
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209030044367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered