Provider Demographics
NPI:1023187069
Name:BUDICK, KAY (RN, CNS)
Entity Type:Individual
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First Name:KAY
Middle Name:
Last Name:BUDICK
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Gender:F
Credentials:RN, CNS
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Mailing Address - Street 1:14315 108TH AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5701
Mailing Address - Country:US
Mailing Address - Phone:708-675-1305
Mailing Address - Fax:708-226-1657
Practice Address - Street 1:14400 JOHN HUMPHREY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2897
Practice Address - Country:US
Practice Address - Phone:708-675-1305
Practice Address - Fax:708-226-1657
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209005432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK13960Medicare UPIN
ILK19401Medicare ID - Type Unspecified