Individual
MRS. KATHERINE EYDELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4318 S STATE ST, CHICAGO, IL 60609-3701
(773) 285-9304
(773) 564-3501
Mailing address
4318 S STATE ST, CHICAGO, IL 60609-3701
(773) 285-9304
(773) 564-3501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018063
IL
363L00000X
Nurse Practitioner
APRN002070
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114390788
—
NV
Enumeration date
11/04/2015
Last updated
10/17/2018
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