MEDICARE: KATHRYN CAREY

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	363LA2100X	Acute Care Nurse Practitioner	XXXXXXXXXXXXX	IL

General Provider Information

NPI Number	:	1427451525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CAREY

Provider Business Mailing Address
First Line	:	1727 W FLETCHER ST # 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3023
Country	:	US
Telephone Number	:	847-791-5289
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 W FLETCHER ST # 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3023
Country	:	US
Telephone Number	:	847-791-5289
Fax Number	:

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

Provider Enumeration Date	:	10/02/2014
Last Update Date	:	10/02/2014

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Directions to “ KATHRYN CAREY ” Practice Location

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