Individual
KATHLEEN CORDEIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2509
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125-054231
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125-054231
TEMPORARY MEDICAL LICENSE #
IL
Enumeration date
08/08/2008
Last updated
02/16/2021
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