Provider Demographics
NPI:1366636417
Name:MCANDREWS, KATHRYN K (APN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:K
Last Name:MCANDREWS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:M
Other - Last Name:KILLEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 054
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-942-6744
Mailing Address - Fax:312-942-3131
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 054
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-6744
Practice Address - Fax:312-942-3131
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-001891363L00000X
IL209-004794364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner