Provider Demographics
NPI:1932401270
Name:BAUMGARTNER, KATHERINE DENISE (MED, ATC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:DENISE
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CHILDREN'S PLAZA
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3363
Mailing Address - Country:US
Mailing Address - Phone:773-327-9926
Mailing Address - Fax:773-327-1166
Practice Address - Street 1:2300 CHILDREN'S PLAZA
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-327-9926
Practice Address - Fax:773-327-1166
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0018502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer