Individual
KATHERINE ANN FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 EASTLAND DR, BLOOMINGTON, IL 61701-3552
(309) 663-8311
(309) 661-3390
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(309) 663-8311
(309) 661-3390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036130971
IL
207R00000X
Internal Medicine Physician
125-54692
IL
208000000X
Pediatrics Physician
125-54692
IL
Other
Enumeration date
06/18/2008
Last updated
05/08/2024
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