Provider Demographics
NPI:1457362519
Name:PATTERSON, KARIN G (DO)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:G
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10607 RANDOLPH STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7504
Mailing Address - Country:US
Mailing Address - Phone:219-663-4007
Mailing Address - Fax:219-663-4198
Practice Address - Street 1:10607 RANDOLPH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7504
Practice Address - Country:US
Practice Address - Phone:219-663-4007
Practice Address - Fax:219-663-4198
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036114553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036114553OtherSTATE LICENSE