Provider Demographics
NPI:1285192385
Name:WINNER, KATHERINE M (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:WINNER
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10350 HALIGUS RD STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9545
Mailing Address - Country:US
Mailing Address - Phone:815-338-6600
Mailing Address - Fax:847-802-7162
Practice Address - Street 1:10350 HALIGUS RD STE A
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9545
Practice Address - Country:US
Practice Address - Phone:815-338-6600
Practice Address - Fax:847-802-7162
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019126363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041-378869OtherRN LICENSE