Provider Demographics
NPI:1356754600
Name:KASINSKI, KAREN CATHERINE
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CATHERINE
Last Name:KASINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E OHIO ST UNIT 4607
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5878
Mailing Address - Country:US
Mailing Address - Phone:262-488-8191
Mailing Address - Fax:
Practice Address - Street 1:4410 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4011
Practice Address - Country:US
Practice Address - Phone:773-254-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0297851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice