Individual
KATHERINE MARIE KUEBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2820 W ARMITAGE AVE STE 7, CHICAGO, IL 60647-6318
(773) 394-0796
(773) 394-3342
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6250
(630) 575-7450
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
070-014323
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634372
BCBS GROUP NO.
IL
01
—
1618443
BCBS GROUP NO.
IL
01
—
200573902
TAX IDENTIFICATION NO.
IL
05
—
236963283001
—
IL
01
—
363396874
TAX IDENTIFICATION NO.
IL
Enumeration date
07/19/2006
Last updated
07/21/2022
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