Provider Demographics
NPI:1366636375
Name:MARKO, KATHRYN I (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:I
Last Name:MARKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:I
Other - Last Name:CHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW
Mailing Address - Street 2:6A-426
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2500
Mailing Address - Fax:202-741-2550
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW
Practice Address - Street 2:6A-426
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2500
Practice Address - Fax:202-741-2550
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.124489207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology