Provider Demographics
NPI:1043351745
Name:CATELLANI, CONSTANCE ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:ANNE
Last Name:CATELLANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7830 KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3512
Mailing Address - Country:US
Mailing Address - Phone:847-673-5300
Mailing Address - Fax:847-673-7063
Practice Address - Street 1:7830 KILBOURN AVE
Practice Address - Street 2:SOUTH ENTRANCE
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3512
Practice Address - Country:US
Practice Address - Phone:847-673-5300
Practice Address - Fax:847-673-7063
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057626207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC-44787Medicare UPIN