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General NPI Number Information
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NPI Number | 1316943848
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Entity Type | Individual
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Provider Name | KATHRYN R BURKE DO
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 3700 W 203RD ST STE 204
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1182
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Country | US
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Telephone | 700-874-8750
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Fax | 708-503-3852
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Provider Business Mailing Address
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Address Line | 35318 EAGLE WAY
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City | CHICAGO
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State | IL
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Zip | 60678-1353
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Country | US
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Telephone | 317-528-4800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 036075518
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036075518
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License Number State | IL
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