Provider Demographics
NPI:1730378720
Name:ADLER, KATHERINE ANN
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANN
Last Name:ADLER
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:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727-0616
Mailing Address - Country:US
Mailing Address - Phone:217-935-9496
Mailing Address - Fax:217-935-2788
Practice Address - Street 1:1150 ROUTE 54 W
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-2148
Practice Address - Country:US
Practice Address - Phone:217-935-9496
Practice Address - Fax:217-935-2788
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program