Provider Demographics
NPI:1972893477
Name:HUML, CATHERINE A (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:HUML
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 1:800 AUDUBON WAY
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3811
Mailing Address - Country:US
Mailing Address - Phone:478-876-2200
Mailing Address - Fax:847-876-2065
Practice Address - Street 1:800 AUDUBON WAY
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3811
Practice Address - Country:US
Practice Address - Phone:847-876-2200
Practice Address - Fax:847-876-2065
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136012208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036136012OtherMEDICAID
IL206147OtherMEDICARE PTAN (GROUP)
ILCA4748OtherMEDICARE RAILROAD (GROUP PTAN)
ILP01388368OtherMEDICARE RAILROAD (INDIVIDUAL PTAN)
ILF400162683OtherMEDICARE PTAN (INDIVIDUAL)