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NPI Code Detail

MEDICARE: DR. KERRI MICHELLE LOCKHART M.D.

MEDICARE: DR. KERRI MICHELLE LOCKHART M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician036.132186IL

General Provider Information

NPI Number : 1013234236
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERRI MICHELLE LOCKHART M.D.
Provider Business Mailing Address
First Line : 1520 N KOSTNER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-1610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1520 N KOSTNER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-1610
Country : US
Telephone Number : 312-216-8020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2010
Last Update Date : 11/24/2014

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Directions to “ DR. KERRI MICHELLE LOCKHART M.D.” Practice Location

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