Provider Demographics
NPI:1477999092
Name:HILL, KATHERINE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:C
Last Name:HILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 CROSSING CT STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-6185
Mailing Address - Country:US
Mailing Address - Phone:217-356-5260
Mailing Address - Fax:217-398-5893
Practice Address - Street 1:2917 CROSSING CT STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-6185
Practice Address - Country:US
Practice Address - Phone:217-356-5260
Practice Address - Fax:217-398-5893
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0274251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice