Provider Demographics
NPI:1790880235
Name:KATZ, CHERYL LYNNE (MD)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNNE
Last Name:KATZ
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR - BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:216-383-5303
Mailing Address - Fax:216-383-5309
Practice Address - Street 1:18599 LAKE SHORE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1071
Practice Address - Country:US
Practice Address - Phone:216-383-5303
Practice Address - Fax:216-383-5309
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7786422OtherAETNA
0111832OtherUNITED HEALTHCARE
341905631028OtherCARESOURCE
OH2329975Medicaid
000000248171OtherANTHEM
7786422OtherAETNA
OH2329975Medicaid