Annie Kluch

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014309 Issued in IL

Practice address

1100 W Veterans Pkwy Ste 200
Yorkville, IL 60560-4728

Phone

(630) 236-4270

Fax

(630) 236-4271

NPI assigned

May 26, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1073961314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W VETERANS PKWY STE 200",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604728",
            "telephone_number": "630-236-4270",
            "fax_number": "630-236-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W VETERANS PKWY STE 200",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605604728",
            "telephone_number": "630-236-4270",
            "fax_number": "630-236-4271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Villa St",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601208001",
            "country_code": "US",
            "telephone_number": "630-892-4720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUCH",
        "first_name": "ANNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Paige King
• King'S Dominion Home Healthcare Services Corporation
• Theresa Lynne Kish, LCPC
• Sheryl Klebenow
• Alyssa Klinsky
• Elizabeth M Koenig, LCSW
• Renee Kohlman, FNP
• Dennis C Kostal, DDS
• Courtney Amanda Kotsch
• Lainey Rae Kovarik

• Family Nurse Practitioner in Yorkville, IL
• Providers in Yorkville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.