Individual
KATHLEEN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3722 HARLEM AVE LOWR LEVEL-34, RIVERSIDE, IL 60546-2312
(708) 783-7840
Mailing address
2368 PAYSPHERE CIR, CHICAGO, IL 60674-2368
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-100206
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100206
—
IL
Enumeration date
07/17/2006
Last updated
07/08/2007
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