Provider Demographics
NPI:1205087954
Name:MARKS, KATHERINE CHILEK (DO)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CHILEK
Last Name:MARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:DOUGLASS
Other - Last Name:CHILEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:115 WOODBINE LANE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821
Mailing Address - Country:US
Mailing Address - Phone:570-271-8050
Mailing Address - Fax:570-271-5940
Practice Address - Street 1:115 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-9118
Practice Address - Country:US
Practice Address - Phone:570-271-8050
Practice Address - Fax:570-271-5940
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015302207N00000X, 207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty