Provider Demographics
NPI:1205014537
Name:KAYSER, CONSTANCE SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:SUE
Last Name:KAYSER
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 1:7111 MINDER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:62563-6122
Mailing Address - Country:US
Mailing Address - Phone:217-498-7369
Mailing Address - Fax:217-498-9167
Practice Address - Street 1:7111 MINDER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IL
Practice Address - Zip Code:62563-6122
Practice Address - Country:US
Practice Address - Phone:217-498-7369
Practice Address - Fax:217-498-9167
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery