Healthcare Provider Details

I. General information

NPI: 1578574802
Provider Name (Legal Business Name): KATHRYN D CAVITT I CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 POTTER RD
DES PLAINES IL
60016-5337
US

IV. Provider business mailing address

895 N WALNUT ST
MANTENO IL
60950
US

V. Phone/Fax

Practice location:
  • Phone: 800-570-8809
  • Fax: 847-759-9448
Mailing address:
  • Phone: 815-468-8341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number41-155407
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: