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General NPI Number Information
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NPI Number | 1518230499
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Entity Type | Individual
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Provider Name | KATI L MCLEOD P.A.
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 15022 N 20TH PL
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City | PHOENIX
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State | AZ
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Zip | 85022-4049
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Country | US
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Telephone | 928-853-7227
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 WARRENVILLE RD SUITE 280
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1748
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Country | US
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Telephone | 630-324-7900
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5060
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3353
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085005565
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License Number State | IL
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