Individual
DR. KATHY BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6131 DEMPSTER ST, MORTON GROVE, IL 60053-2953
(847) 967-5010
(847) 967-5147
Mailing address
6131 DEMPSTER ST, MORTON GROVE, IL 60053-2953
(847) 967-5010
(847) 967-5147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036071337
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632926
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/07/2005
Last updated
12/15/2021
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