Individual
KATHLEEN W FLORENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4400 W 95TH ST STE 306, OAK LAWN, IL 60453-2659
(708) 684-5428
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036101634
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621490
BCBS PROVIDER ID
IL
05
—
036101634
—
IL
01
—
250011628
RAILROAD MEDICARE
IL
01
—
36354817310
ADVOCATE HLTH CENTERS ID
IL
01
—
47626
ADVOCATE HLTH PARTNERS ID
IL
Enumeration date
09/21/2005
Last updated
02/21/2023
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