Moline, Kathleen Carroll
Moline, Kathleen Carroll is an sole proprietor health care provider with primary practice located at 1800 N Main St Ste 102 , Wheaton IL 60187-3112. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Moline, Kathleen Carroll can be contacted via phone (630) 260-0600.Contact Information
Primary practice address
1800 N Main St Ste 102
Wheaton IL 60187-3112
Phone: (630) 260-0600
Fax: (630) 260-1370
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 125-049243 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036119323 | Illinois |
Profile Details
| NPI number | 1730373259 |
|---|---|
| LBN Legal business name | Moline, Kathleen Carroll |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 28th, 2007 |
| Last updated | Jan 13th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730373259 | NPPES |
| Illinois | Other | P00646859 | MEDICARE RAILROAD PTAN (INDIVIDUAL) |
| Illinois | Other | R03102 | MEDICARE RAILROAD PTAN (INDIVIDUAL) |
| Illinois | Other | 548190 | MEDICARE RAILROAD PTAN (INDIVIDUAL) |
| Illinois | Other | CA4748 | MEDICARE RAILROAD PTAN (INDIVIDUAL) |
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