Individual
DR. KATHLEEN A. HODGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
453 S VERMONT ST STE C, PALATINE, IL 60067-6968
(913) 359-6001
(319) 359-5552
Mailing address
6601 COLLEGE BLVD STE 120, OVERLAND PARK, KS 66211-1504
(913) 359-6001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036048484
IL
207Q00000X
Family Medicine Physician
36048484
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048484
—
IL
01
—
04900710
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/27/2006
Last updated
11/07/2023
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