Individual
KATHRYN R BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3700 W 203RD ST STE 204, OLYMPIA FIELDS, IL 60461-1182
(700) 874-8750
(708) 503-3852
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036075518
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036075518
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075518
—
IL
01
—
534220
GROUP MEDICARE NUMBER
IL
01
—
F400311566
MEDICARE IL PTAN
IL
Enumeration date
06/21/2005
Last updated
05/18/2022
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