Provider Demographics
NPI:1578543492
Name:ZABOR, KATHLEEN M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:M
Last Name:ZABOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4885 HOFFMAN BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-3722
Mailing Address - Country:US
Mailing Address - Phone:847-255-9697
Mailing Address - Fax:847-645-6431
Practice Address - Street 1:4885 HOFFMAN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-3722
Practice Address - Country:US
Practice Address - Phone:847-255-9697
Practice Address - Fax:847-645-6431
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085002197363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00213949OtherRRMC
IL01633451OtherBCBS
IL210105OtherGROUP PTAN
IL1871613489OtherGROUP NPI
ILP00213949OtherRRMC
IL210105OtherGROUP PTAN
ILR02128Medicare PIN