Provider Demographics
NPI:1780663963
Name:SIMPSON, KAREEN ROSE ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:KAREEN
Middle Name:ROSE ELIZABETH
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S DESPLAINES ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5500
Mailing Address - Country:US
Mailing Address - Phone:312-654-2720
Mailing Address - Fax:312-654-9930
Practice Address - Street 1:210 S DESPLAINES ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-5500
Practice Address - Country:US
Practice Address - Phone:312-654-2720
Practice Address - Fax:866-597-9534
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105119207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036105119Medicaid
IL036105119Medicaid
H41980Medicare UPIN