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Organization
K C A S ENT INC.
Active
Organization
K C A S ENT INC.
Active
Other names
Child Assessment/Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN L LUDWIKOWSKI APN (ADVANCED PRACTICE NURSE PRACTITIONE)
(815) 568-0243
Entity
Organization
Contact information
Practice address
706 N TAYLOR ST, MARENGO, IL 60152-2457
(815) 568-0243
(815) 568-5350
Mailing address
706 N TAYLOR ST, MARENGO, IL 60152-2457
(815) 568-0243
(815) 568-5350
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209000890
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341407830001
—
IL
Enumeration date
08/13/2005
Last updated
11/24/2010
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