Bottum, Kathleen M

Bottum, Kathleen M is an individual health care provider with primary practice located at 751 N Rutledge St Ste 1700 , Springfield IL 62702. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Bottum, Kathleen M can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
751 N Rutledge St Ste 1700 Springfield IL 62702
Phone: (217) 545-8000
Fax: (217) 545-8163
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-106435 Illinois
Allopathic & Osteopathic Physicians / Psychosomatic Medicine 2084P0015X 036-106742 Illinois
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036-106742 Illinois

Profile Details

NPI number 1124003025
LBN Legal business name Bottum, Kathleen M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Oct 20th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124003025 NPPES
Illinois MEDICAID 036106435

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