Provider Demographics
NPI:1568116374
Name:TAYLOR, KATHERINE B (APRN)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:B
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:B
Other - Last Name:KOHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:25 N WINFIELD RD STE 2202
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-307-7799
Mailing Address - Fax:630-307-2277
Practice Address - Street 1:25 N WINFIELD RD STE 2202
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-307-7799
Practice Address - Fax:630-307-2277
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209027112363L00000X
SC25600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily