Provider Demographics
NPI:1437399961
Name:CAVATO, KATHLEEN BYRNE (APN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BYRNE
Last Name:CAVATO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 W 95TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2362
Mailing Address - Country:US
Mailing Address - Phone:708-499-9800
Mailing Address - Fax:708-499-6203
Practice Address - Street 1:5851 W 95TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2362
Practice Address - Country:US
Practice Address - Phone:708-499-9800
Practice Address - Fax:708-499-6203
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002916367A00000X
IL209-002916363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6502002Medicare PIN
ILIL6503002Medicare PIN