Provider Demographics
NPI:1831170356
Name:LOUIE, KAREN G (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:G
Last Name:LOUIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MIDWEST CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2507
Mailing Address - Country:US
Mailing Address - Phone:630-212-1554
Mailing Address - Fax:630-323-6396
Practice Address - Street 1:107 MIDWEST CLUB PKWY
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2507
Practice Address - Country:US
Practice Address - Phone:630-212-1554
Practice Address - Fax:630-323-6396
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061154207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061154Medicaid
G42892Medicare UPIN