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NPI Code Detail

MEDICARE: DR. KATHLEEN CASPER D.O.

MEDICARE: DR. KATHLEEN CASPER D.O.
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
1207Q00000XFamily Medicine Physician036066773IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912004912
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN CASPER D.O.
Provider Business Mailing Address
First Line : 10660 W 143RD ST STE B
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-1989
Country : US
Telephone Number : 708-349-0055
Fax Number : 708-460-8031
Provider Business Practice Location Address
First Line : 3235 W 111TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60655-2730
Country : US
Telephone Number : 773-445-2802
Fax Number : 773-445-9983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/03/2008

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Directions to “ DR. KATHLEEN CASPER D.O.” Practice Location

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