Provider Demographics
NPI:1881743227
Name:BALDWIN, KATHLEEN COOPER (MD)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:COOPER
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:151 N MICHIGAN AVE
Mailing Address - Street 2:#810
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7506
Mailing Address - Country:US
Mailing Address - Phone:312-861-9498
Mailing Address - Fax:847-251-6034
Practice Address - Street 1:151 N MICHIGAN AVE
Practice Address - Street 2:#810
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7506
Practice Address - Country:US
Practice Address - Phone:312-861-9498
Practice Address - Fax:847-251-6034
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL03183Medicare ID - Type Unspecified
E21491Medicare UPIN
IL752310Medicare ID - Type Unspecified