Provider Demographics
NPI:1689776973
Name:HELGASON, CATHY A
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:HELGASON
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 1:912 S WOOD ST
Mailing Address - Street 2:DEPT. OF NEUROLOGY, ROOM 855N (M/C 796)
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4300
Mailing Address - Country:US
Mailing Address - Phone:312-996-6496
Mailing Address - Fax:312-996-4169
Practice Address - Street 1:1740 W TAYLOR ST
Practice Address - Street 2:NEUROSCIENCE CENTER, ROOM 4E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7232
Practice Address - Country:US
Practice Address - Phone:312-355-0510
Practice Address - Fax:312-413-7704
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0641352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43164Medicare UPIN
ILK25959Medicare ID - Type Unspecified