Healthcare Provider Details

I. General information

NPI: 1851675425
Provider Name (Legal Business Name): CATHERINE MARY GERACI APN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

IV. Provider business mailing address

6501 S PROMONTORY DR
CHICAGO IL
60649-1003
US

V. Phone/Fax

Practice location:
  • Phone: 800-770-2232
  • Fax: 773-363-7143
Mailing address:
  • Phone: 800-770-2232
  • Fax: 773-363-7143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number209.008107
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: