Provider Demographics
NPI:1104482769
Name:HILL, CATHERINE L
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:HILL
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 1:2831 BILDAHL ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61109-1136
Mailing Address - Country:US
Mailing Address - Phone:779-772-0698
Mailing Address - Fax:
Practice Address - Street 1:2831 BILDAHL ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61109-1136
Practice Address - Country:US
Practice Address - Phone:779-772-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-18
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide