Provider Demographics
NPI:1982634614
Name:CATT, KARYN EMMANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KARYN
Middle Name:EMMANUEL
Last Name:CATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARYN
Other - Middle Name:LYNETTE
Other - Last Name:EMMANUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1117 HANSON DR
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-1881
Mailing Address - Country:US
Mailing Address - Phone:309-660-2266
Mailing Address - Fax:
Practice Address - Street 1:1117 HANSON DR
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-1881
Practice Address - Country:US
Practice Address - Phone:309-660-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040462A2084N0400X
IL0361094102084N0600X, 2084N0400X, 246ZE0600X, 2084N0400X
WAMD60329057246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2613OtherMEDICARE GROUP #
IL2613OtherMEDICARE GROUP #
ILG72690Medicare UPIN