Provider Demographics
NPI:1518842475
Name:KOZLOWSKI, KIMBERLY ANN (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 FOXGLOVE DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-6319
Mailing Address - Country:US
Mailing Address - Phone:847-691-9349
Mailing Address - Fax:847-691-9349
Practice Address - Street 1:730 FOXGLOVE DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-6319
Practice Address - Country:US
Practice Address - Phone:224-241-2068
Practice Address - Fax:847-691-9349
Is Sole Proprietor?:No
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.422004163WN0300X, 163WN1003X, 171400000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No171400000XOther Service ProvidersHealth & Wellness Coach