Provider Demographics
NPI:1164417135
Name:DRINAN, KATHLEEN J (DO)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:J
Last Name:DRINAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14290 S LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2023
Mailing Address - Country:US
Mailing Address - Phone:773-702-9461
Mailing Address - Fax:773-834-7374
Practice Address - Street 1:14290 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2023
Practice Address - Country:US
Practice Address - Phone:773-702-9461
Practice Address - Fax:773-834-7374
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066784207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL11688OtherADVOCATE HLTH PARTNERS ID
IL01623302OtherBCBS PROVIDER ID
IL036066784Medicaid
IL060052681OtherRAILROAD MEDICARE
IL36427783600OtherADVOCATE HLTH CENTERS ID
IL36427783600OtherADVOCATE HLTH CENTERS ID
IL060052681OtherRAILROAD MEDICARE
ILC51226Medicare UPIN