Kimberly Summers
Individual provider Active NPI Licensed Practical Nurse · Carrollton, IL
NPI 1396534871 · NPPES record last updated May 2, 2025
Key facts
- NPI
- 1396534871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 043078572 (IL)
- Practice address
- 121 S Main St
Carrollton, IL 62016-1340 - Phone
- (217) 939-0236
- NPI assigned
- May 2, 2025
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 043078572 | IL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043078572 | IL | Yes |
Addresses
Primary practice location
121 S Main St
Carrollton, IL 62016-1340
Mailing address
202 Bruce Dr
White Hall, IL 62092-1178
Phone (217) 939-1307
Other providers in Carrollton, IL
- Mohammed W Siddiqui
- Jonnelle D Smith
- Morgan Stein
- Keli Stewart
- William B Sturm
- Thomas H. Boyd Memorial Hospital
- Thomas H. Boyd Memorial Hospital
- Thomas H. Boyd Memorial Hospital
- Thomas H. Boyd Memorial Hospital
- James Uhles
All providers in Carrollton, IL · Licensed Practical Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.