Organization
KATHLEEN CASPER, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN CASPER D.O. (OWNER)
(773) 445-2802
Entity
Organization
Contact information
Practice address
3235 W 111TH ST, CHICAGO, IL 60655-2730
(773) 445-2802
(773) 445-9983
Mailing address
10660 W 143RD ST, SUITE B, ORLAND PARK, IL 60462-1982
(708) 349-0055
(708) 460-8031
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036066773
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
036066773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600471
BLUE CROSS BLUE SHIELD
IL
01
—
CB1617
PALMETTO RR MEDICARE
IL
Enumeration date
01/02/2008
Last updated
12/03/2008
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