Healthcare Provider Details

I. General information

NPI: 1508360645
Provider Name (Legal Business Name): CATHERINE BORDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S CALIFORNIA AVE
CHICAGO IL
60608-1858
US

IV. Provider business mailing address

2500 Q ST NW APT 644
WASHINGTON DC
20007-4347
US

V. Phone/Fax

Practice location:
  • Phone: 773-522-2010
  • Fax:
Mailing address:
  • Phone: 847-778-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036159854
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: