Individual
MRS. KATHLEEN ELIZABETH ANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1475 E BELVIDERE RD, GRAYSLAKE, IL 60030-2012
(847) 582-2134
(847) 535-7285
Mailing address
1475 E BELVIDERE RD, GRAYSLAKE, IL 60030-2012
(847) 582-2134
(847) 535-7285
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004295
IL
363A00000X
Physician Assistant
PA07666
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293923301
—
TX
01
—
875N69
BCBS
TX
Enumeration date
03/02/2012
Last updated
01/03/2024
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