Individual
KAITLIN ROSE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
747 N RUTLEDGE ST FL 5, SPRINGFIELD, IL 62702-6700
(217) 545-3262
Mailing address
PO BOX 19665, SPRINGFIELD, IL 62794-9665
(913) 486-0338
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
125.079880
IL
Other
Enumeration date
04/15/2021
Last updated
07/07/2022
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