Organization · Type 2 NPI
Katrina Lake MD LLC
Multi-Specialty Clinic/Center · Country Club Hills, IL
NPI number
1013536663
Active
Practice location
18503 Bellamy Rd
Country Club Hills, IL 60478-5279
Other practice locations
- 4053 183rd St Unit 2326, Country Club Hills, IL 60478-3413 · (708) 365-8343
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
About NPI 1013536663
Katrina Lake MD LLC's National Provider Identifier is 1013536663, issued on Apr 14, 2020. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Country Club Hills, IL. The record was last updated on May 1, 2020.