Katherine Diane Accomando

Individual provider Active NPI Licensed Practical Nurse · McHenry, IL

NPI 1154488039 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154488039
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
43042836 (IL)
Practice address
1219 Blackhawk Ave
McHenry, IL 60051-9326
Phone
(815) 385-1212
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
43042836ILMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 43042836 IL Yes

Addresses

Primary practice location

1219 Blackhawk Ave
McHenry, IL 60051-9326

Mailing address

1115 Boneset Dr
Crystal Lake, IL 60014-6977
Phone (815) 356-1588

Other providers in McHenry, IL

All providers in McHenry, IL · Licensed Practical Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.