MEDICARE: KATHLEEN BRIDGET FREEMAN

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	363A00000X	Physician Assistant	085.011786	IL

General Provider Information

NPI Number	:	1225872765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN BRIDGET FREEMAN

Provider Business Mailing Address
First Line	:	334 N CATHERINE AVE
Second Line	:
City	:	LA GRANGE PARK
State	:	IL
Zip	:	60526-2003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 W CENTRAL RD STE 5000
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2384
Country	:	US
Telephone Number	:	847-618-1000
Fax Number	:

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

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	12/08/2025

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