Provider Demographics
NPI:1992417950
Name:KESSLER, KIRSTEN L (ND)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:L
Last Name:KESSLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60087-5338
Mailing Address - Country:US
Mailing Address - Phone:619-997-0262
Mailing Address - Fax:
Practice Address - Street 1:1800 NATIONS DR STE 117-3
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-9171
Practice Address - Country:US
Practice Address - Phone:224-513-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
IL164.009644133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No175F00000XOther Service ProvidersNaturopath