Healthcare Provider Details

I. General information

NPI: 1720234834
Provider Name (Legal Business Name): KATHLEEN CORDEIRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 WAUKEGAN RD
GLENVIEW IL
60025-2120
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-832-6500
  • Fax: 847-832-6040
Mailing address:
  • Phone: 847-570-2040
  • Fax: 847-733-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036126975
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: