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Contact Information

KIMBERLY M MATHIS HARRIS
10908 S HALSTED ST
CHICAGO, IL60628-3128
 Phone: 773-339-6556
 Fax: 773-701-6055
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optician

156FX1800X 96[5] Optician
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for KIMBERLY M MATHIS HARRIS · (Female)

NPI Number 1619566627
Status Active
Credentials
Entity Individual
Enumeration date 01/14/2021
Last updated 05/28/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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