Healthcare Provider Details

I. General information

NPI: 1437303872
Provider Name (Legal Business Name): KATHRYN KANE RPSGT, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN J COE

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S MILWAUKEE AVE STE 201
LAKE VILLA IL
60046-5426
US

IV. Provider business mailing address

7625 328TH AVE
BURLINGTON WI
53105-8833
US

V. Phone/Fax

Practice location:
  • Phone: 847-838-9253
  • Fax: 888-608-0343
Mailing address:
  • Phone: 847-778-3216
  • Fax: 888-608-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: