Basic Information
| Provider Information | |||||||||
| NPI: | 1487638763 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EUBANKS | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 199 W RAND RD | ||||||||
| Address2: | #203 | ||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600561129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476185450 | ||||||||
| FaxNumber: | 8476185459 | ||||||||
| Practice Location | |||||||||
| Address1: | 199 W RAND RD | ||||||||
| Address2: | #203 | ||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600561129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476185450 | ||||||||
| FaxNumber: | 8476185459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 04/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036095417 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.