MEDICARE: KATIE HAMILTON WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	209.008293	IL

General Provider Information

NPI Number	:	1508172875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE HAMILTON WHNP

Provider Business Mailing Address
First Line	:	900 N KINGSBURY ST
Second Line	:	SUITE 130 N
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-775-1100
Fax Number	:	312-775-1111

Provider Business Practice Location Address
First Line	:	900 N KINGSBURY ST
Second Line	:	SUITE 130 N
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-775-1100
Fax Number	:	312-775-1111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2010
Last Update Date	:	06/08/2011

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