Basic Information
| Provider Information | |||||||||
| NPI: | 1134438740 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMP | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RN, GNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 W ROSEMONT AVE | ||||||||
| Address2: | 1E | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606601319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7734652358 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9977 WOODS DR | ||||||||
| Address2: | FLOOR 1 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600771057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476638540 | ||||||||
| FaxNumber: | 8476631015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2010 | ||||||||
| LastUpdateDate: | 09/29/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 209.002028 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.