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Individual
DR. KATHLEEN CARROLL MOLINE
Active
Individual
DR. KATHLEEN CARROLL MOLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036119323
IL
207Q00000X
Family Medicine Physician
125-049243
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
548190
MEDICARE PTAN (GROUP)
IL
01
—
CA4748
MEDICARE RAILROAD PTAN (GROUP)
IL
01
—
P00646859
MEDICARE RAILROAD PTAN (INDIVIDUAL)
IL
01
—
R03102
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/28/2007
Last updated
01/13/2020
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