Provider Demographics
NPI:1700226982
Name:BITTNER, KATIE MERIB (DO)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MERIB
Last Name:BITTNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:611 W PARK ST
Mailing Address - Street 2:BWPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2529
Mailing Address - Country:US
Mailing Address - Phone:217-383-6941
Mailing Address - Fax:
Practice Address - Street 1:1818 E WINDSOR RD
Practice Address - Street 2:FAMILY MED
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-9566
Practice Address - Country:US
Practice Address - Phone:217-255-9500
Practice Address - Fax:217-255-9724
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.140415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine