Provider Demographics
NPI:1659071868
Name:WEST, CATALINA
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 SEVEN PINES RD APT 202
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-5741
Mailing Address - Country:US
Mailing Address - Phone:217-671-3666
Mailing Address - Fax:
Practice Address - Street 1:304 W HAY ST STE 212
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-6376
Practice Address - Country:US
Practice Address - Phone:217-876-4390
Practice Address - Fax:217-876-4395
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026829207RI0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease