Individual
MS. KATE W. FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 BIESTERFIELD RD STE G01, WIMMER BUILDING, ELK GROVE VILLAGE, IL 60007-3372
(847) 981-3680
(847) 956-5122
Mailing address
900 S FRONTAGE RD, SUITE 325, WOODRIDGE, IL 60517-4903
(847) 981-3680
(847) 956-5122
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003615
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720371669
NPI GROUP PRACTICE
IL
01
—
IL6304021
MEDICARE PIN-LOC 16
IL
01
—
IL6305021
MEDICARE PIN-LOC 15
IL
01
—
P01058191
RRMC PTAN
IL
Enumeration date
10/20/2009
Last updated
01/30/2013
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