Individual
KATHLEEN A MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1801 S HIGHLAND AVE STE 130, LOMBARD, IL 60148-4932
(630) 627-4722
(630) 627-9134
Mailing address
1801 S HIGHLAND AVE STE 130, LOMBARD, IL 60148-4932
(630) 627-4722
(630) 627-9134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301093916
MI
207R00000X
Internal Medicine Physician
4301093916
MI
208000000X
Pediatrics Physician
4301093916
MI
Other
Enumeration date
07/06/2006
Last updated
12/06/2016
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