Provider Demographics
NPI:1518947555
Name:LADEMANN, KATHLEEN (RN MSN APN CWCN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:LADEMANN
Suffix:
Gender:F
Credentials:RN MSN APN CWCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1612 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1729
Mailing Address - Country:US
Mailing Address - Phone:630-961-9004
Mailing Address - Fax:
Practice Address - Street 1:608 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6663
Practice Address - Country:US
Practice Address - Phone:630-898-3360
Practice Address - Fax:630-898-3358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL364SC2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQ35638Medicare UPIN
ILK14678Medicare ID - Type Unspecified