Forster Ivy, Kelly Kathleen

Forster Ivy, Kelly Kathleen is an individual health care provider with primary practice located at 900 N Westmoreland Rd Ste 112 , Lake Forest IL 60045. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Obstetric, Inpatient, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Forster Ivy, Kelly Kathleen can be contacted via phone (847) 535-7057.

Contact Information

Primary practice address
900 N Westmoreland Rd Ste 112 Lake Forest IL 60045
Phone: (847) 535-7057
Fax: (847) 615-2260
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Obstetric, Inpatient 163WX0003X 041369474 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 209009824 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 277001068 Illinois

Profile Details

NPI number 1649514316
LBN Legal business name Forster Ivy, Kelly Kathleen
Credentials CNM, WHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2012
Last updated May 8th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649514316 NPPES
Illinois Other 209010141 STATE LICENSE

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