Healthcare Provider Details

I. General information

NPI: 1144616897
Provider Name (Legal Business Name): KATHRYN L CHUBRILO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

5600 S QUEBEC ST STE 312A
GREENWOOD VILLAGE CO
80111-2208
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-2727
  • Fax:
Mailing address:
  • Phone: 303-436-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number036149249
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number9030
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number9030
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: