KATHLEEN MCCLESKEY-GRIMES (NPI# 1467640193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467640193 |
| Entity Type | Individual |
| Full Name | KATHLEEN MCCLESKEY-GRIMES |
| Practice Address |
1305 Randall Rd Crystal Lake IL 60014-8601 |
| Practice Telephone | 8663892727 |
| Mailing Telephone | 8158858684 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.006546 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209006546 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6506 N Alpine Rd, Loves Park, IL 611114353 | 8156336666 |
| Street Address |
1305 RANDALL RD |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-8601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326554130 | Cvs Aoc Services, L.L.C. | Optometrist | 1305 Randall Rd, Crystal Lake, IL 60014-8601 | 2017-12-18 |
| 1639526015 | Rachelle Puno | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014 | 2016-05-16 |
| 1598173734 | Kyle Schneider | Pharmacist | 1305 Randall Rd, Crystal Lake, IL 60014-8601 | 2014-07-31 |
| 1639355126 | Suzanne Herrera Phipps | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014-8601 | 2008-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861785032 | Sharon E. Larsen | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2011-05-22 |
| 1801351648 | Jennifer A Garrels | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2019-02-06 |
| 1760956726 | Cardinalight Health, LLC | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2019-01-13 |
| 1780157602 | Well-rooted Pediatrics LLC | Nurse Practitioner | 820 E Terra Cotta Ave Ste 132, Crystal Lake, IL 60014-3655 | 2019-01-03 |
| 1861987604 | Lisa M Trautman | Nurse Practitioner | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-06-25 |
| 1538600820 | Catherine Arend | Nurse Practitioner | 741 S Mchenry Ave, Suite G, Crystal Lake, IL 60014-7445 | 2017-03-20 |
| 1265972418 | Lauren K Mielke | Nurse Practitioner | 781 S Mchenry Ave, Crystal Lake, IL 60014-7444 | 2017-03-06 |
| 1639526015 | Rachelle Puno | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014 | 2016-05-16 |
| 1386099208 | Roseann C Iverson | Nurse Practitioner | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1725 | 2016-04-28 |
| 1023424389 | Kristine M Redmond | Nurse Practitioner | 442 N Il Route 31, Crystal Lake, IL 60012-3709 | 2014-07-08 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on KATHLEEN MCCLESKEY-GRIMES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.