Healthcare Provider Details

I. General information

NPI: 1538713821
Provider Name (Legal Business Name): MRS. KATHLEEN DOWLING BARBIYERU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST STE 301
HINSDALE IL
60521-3625
US

IV. Provider business mailing address

908 N ELM ST STE 301
HINSDALE IL
60521-3625
US

V. Phone/Fax

Practice location:
  • Phone: 630-794-9999
  • Fax: 630-794-9998
Mailing address:
  • Phone: 630-794-9999
  • Fax: 630-794-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209019630
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: