Provider Demographics
NPI:1184684821
Name:KAISER, PAMELA E (MD)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:E
Last Name:KAISER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:KAISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 LUTHER LN # 2200
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1270
Mailing Address - Country:US
Mailing Address - Phone:847-268-8200
Mailing Address - Fax:847-318-2905
Practice Address - Street 1:1700 LUTHER LN
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1270
Practice Address - Country:US
Practice Address - Phone:847-268-8200
Practice Address - Fax:847-318-2905
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095774207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL86161OtherPIN
IL036095774Medicaid
ILL86161OtherPIN