Provider Demographics
NPI:1548023997
Name:MARTINSON, KATHERINE (DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:MARTINSON
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 COUNT FLEET CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6805
Mailing Address - Country:US
Mailing Address - Phone:847-989-9847
Mailing Address - Fax:
Practice Address - Street 1:845 S DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3727
Practice Address - Country:US
Practice Address - Phone:847-989-9847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.341794163W00000X
ILL-28328163WL0100X
209.028093367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant