MEDICARE: KATELIN PATTERSON

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
1	225700000X	Massage Therapist	227.017584	IL

General Provider Information

NPI Number	:	1164386439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELIN PATTERSON

Provider Business Mailing Address
First Line	:	2105 N SOUTHPORT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4069
Country	:	US
Telephone Number	:	872-225-2256
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 N SOUTHPORT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4069
Country	:	US
Telephone Number	:	872-225-2256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ KATELIN PATTERSON ” Practice Location

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