MEDICARE: DR. KATHERINE SUZANNE DELGADILLO O.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
1	152W00000X	Optometrist	046-009455	IL

General Provider Information

NPI Number	:	1194763359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE SUZANNE DELGADILLO O.D.

Provider Business Mailing Address
First Line	:	2622 W AUTUMN DR
Second Line	:
City	:	ROUND LAKE
State	:	IL
Zip	:	60073-5260
Country	:	US
Telephone Number	:	847-924-5751
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 FEINBERG CT
Second Line	:
City	:	CARY
State	:	IL
Zip	:	60013-2976
Country	:	US
Telephone Number	:	847-516-3111
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	05/08/2024

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