Provider Demographics
NPI:1861034365
Name:MCDONALD, KRISTY LEE (NP)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:LEE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:LEE
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1661 FEEHANVILLE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6017
Mailing Address - Country:US
Mailing Address - Phone:847-305-8600
Mailing Address - Fax:847-305-8601
Practice Address - Street 1:1661 FEEHANVILLE DR STE 120
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6017
Practice Address - Country:US
Practice Address - Phone:847-305-8600
Practice Address - Fax:847-305-8601
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN302004363LF0000X
IL209031003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily