Individual
DR. KATHLEEN M. WEBER
Active
Individual
DR. KATHLEEN M. WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
036099936
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036099936 2
—
IL
01
—
1633878
BCBS GROUP #
IL
01
—
207067
MEDICARE PTIN LOCALITY 16
IL
01
—
207073
MEDICARE PTAN LOCALITY 15
IL
01
—
7785085
AETNA ID#
IL
01
—
DA4902
RR MEDICARE PTAN #
IL
01
—
P00091153
RR MEDICARE ID#
IL
Enumeration date
01/09/2006
Last updated
11/20/2009
Update your record
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