Healthcare Provider Details

I. General information

NPI: 1871743146
Provider Name (Legal Business Name): KATE CATANZANO ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E SCHILLER ST SUITE 318
ELMHURST IL
60126-2858
US

IV. Provider business mailing address

314 N RUSSEL ST
MOUNT PROSPECT IL
60056-2447
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-1775
  • Fax:
Mailing address:
  • Phone: 617-771-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209006468
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: