Provider Demographics
NPI:1003936766
Name:CADET-SAINTILUS, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CADET-SAINTILUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 N GLEN PARK PLACE RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-4675
Mailing Address - Country:US
Mailing Address - Phone:309-683-5700
Mailing Address - Fax:309-683-5752
Practice Address - Street 1:5111 N GLEN PARK PLACE RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-4675
Practice Address - Country:US
Practice Address - Phone:309-683-5700
Practice Address - Fax:309-683-5752
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036120448Medicaid
WA8388878Medicaid
ILP00680133OtherRR MEDICARE MEMBER PTAN
IL809840OtherMEDICARE GROUP #
ILCA4079OtherRR MEDICARE GROUP PTAN
R01674Medicare PIN
WAG8802965Medicare PIN
IL036120448Medicaid
WAP00343904Medicare PIN