Healthcare Provider Details

I. General information

NPI: 1164417135
Provider Name (Legal Business Name): KATHLEEN J DRINAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14290 S LA GRANGE RD
ORLAND PARK IL
60462-2023
US

IV. Provider business mailing address

14290 S LA GRANGE RD
ORLAND PARK IL
60462-2023
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-9461
  • Fax: 773-834-7374
Mailing address:
  • Phone: 773-702-9461
  • Fax: 773-834-7374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036066784
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: