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General NPI Number Information
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NPI Number | 1437362035
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Entity Type | Individual
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Provider Name | KATHLEEN ELYN O'MARA DO
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2000 E LAYTON AVE
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City | ST FRANCIS
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State | WI
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Zip | 53235-6053
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Country | US
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Telephone | 414-744-6589
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 5101016080
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 3970
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 54446
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License Number State | WI
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