Basic Information
| Provider Information | |||||||||
| NPI: | 1972893477 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUML | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 800 AUDUBON WAY | ||||||||
| Address2: | |||||||||
| City: | LINCOLNSHIRE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600693811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4788762200 | ||||||||
| FaxNumber: | 8478762065 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 AUDUBON WAY | ||||||||
| Address2: | |||||||||
| City: | LINCOLNSHIRE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600693811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478762200 | ||||||||
| FaxNumber: | 8478762065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2011 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036136012 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 036136012 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 036136012 | 01 | IL | MEDICAID | OTHER | 206147 | 01 | IL | MEDICARE PTAN (GROUP) | OTHER | CA4748 | 01 | IL | MEDICARE RAILROAD (GROUP PTAN) | OTHER | P01388368 | 01 | IL | MEDICARE RAILROAD (INDIVIDUAL PTAN) | OTHER | F400162683 | 01 | IL | MEDICARE PTAN (INDIVIDUAL) | OTHER |