Provider Demographics
NPI:1730264540
Name:RATHMANN, KRISTIE ANN (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:ANN
Last Name:RATHMANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 NEWARK LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3408
Mailing Address - Country:US
Mailing Address - Phone:847-843-1805
Mailing Address - Fax:
Practice Address - Street 1:1001 N RANDALL RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2319
Practice Address - Country:US
Practice Address - Phone:847-468-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.009857152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist