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NPI Code Detail

MEDICARE: KAITLYN BURKE NP

MEDICARE:   KAITLYN  BURKE  NP
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
1363LW0102XWomen's Health Nurse Practitioner209.024894IL

General Provider Information

NPI Number : 1861140717
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN BURKE NP
Provider Business Mailing Address
First Line : 2425 W 22ND ST STE 200
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-4649
Country : US
Telephone Number : 630-954-0054
Fax Number : 630-954-0064
Provider Business Practice Location Address
First Line : 2425 W 22ND ST STE 200
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-4649
Country : US
Telephone Number : 630-954-0054
Fax Number : 630-954-0064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2022
Last Update Date : 03/10/2022

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