Provider Demographics
NPI:1740093152
Name:CARLSON, KATHLEEN ERIN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ERIN
Last Name:CARLSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 N BARRINGTON RD STE 3450
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1031
Mailing Address - Country:US
Mailing Address - Phone:847-882-2400
Mailing Address - Fax:
Practice Address - Street 1:1555 N BARRINGTON RD STE 3450
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1031
Practice Address - Country:US
Practice Address - Phone:847-882-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN189146163W00000X
IL041373468163W00000X
AZ322473363LF0000X
IL209031697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse