Individual
KATHLEEN CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-2400
Mailing address
10524 EUCLID AVE # 13-117, CLEVELAND, OH 44106-2205
(216) 844-5061
(216) 844-5833
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-061231
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224254
UNISON
OH
01
—
000000532967
ANTHEM
OH
05
—
0973666
—
OH
01
—
260021589
RAILROAD MEDICARE
OH
01
—
363429
WELLCARE MEDICAID
OH
01
—
4662665
AETNA
OH
01
—
P00929247
MEDICARE RAILROAD
OH
Enumeration date
07/25/2006
Last updated
01/06/2021
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