Individual
KATHLEEN MARGARET MCGOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
430 WARRENVILLE RD # 230, LISLE, IL 60532-1348
(630) 693-6437
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-1782
(630) 469-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005947
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4025370
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
—
Enumeration date
08/30/2016
Last updated
03/23/2021
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