Cornell, Kathleen N

Cornell, Kathleen N is an individual health care provider with primary practice located at 3880 Salem Lake Dr Ste F , Long Grove IL 60047-5292. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Cornell, Kathleen N can be contacted via phone (847) 719-2220.

Contact Information

Primary practice address
3880 Salem Lake Dr Ste F Long Grove IL 60047-5292
Fax: (847) 719-2265
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 385000378 Illinois

Profile Details

NPI number 1447295381
LBN Legal business name Cornell, Kathleen N
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Mar 7th, 2023 - about last year

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 1447295381 NPPES
Illinois MEDICAID 085001000

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