Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen Kisseberth

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1275279366

Kathleen Kisseberth is a Student in an Organized Health Care Education/Training Program in Maywood, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (888) 584-7888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 125.083669 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1275279366
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 11, 2022
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024
Mailing address2160 S 1st Ave, Maywood, IL 60153-3328

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