| Kathleen Casper, D.o., P.c. | |
|
3235 W 111th St Chicago IL 60655-2730 | |
| (773) 445-2802 | |
| (773) 445-9983 |
| Full Name | Kathleen Casper, D.o., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3235 W 111th St, Chicago, Illinois |
| Authorized Official Name and Position | Kathleen Casper (OWNER) |
| Authorized Official Contact | 7734452802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Casper, D.o., P.c. 10660 W 143rd St Suite B Orland Park IL 60462-1982 Ph: (708) 349-0055 | Kathleen Casper, D.o., P.c. 3235 W 111th St Chicago IL 60655-2730 Ph: (773) 445-2802 |
| NPI Number | 1205011822 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205011822 | NPI | - | NPPES |
| 0031600471 | Other | IL | BLUE CROSS BLUE SHIELD |
| CB1617 | Other | IL | PALMETTO RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036066773 (Illinois) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 036066773 (Illinois) | Secondary |
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