Provider Demographics
NPI:1215998653
Name:KATO, KAREN S (OD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:KATO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:31016 PRAIRIE RIDGE CT S
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-4899
Mailing Address - Country:US
Mailing Address - Phone:847-688-2616
Mailing Address - Fax:847-688-2382
Practice Address - Street 1:3001 6TH ST
Practice Address - Street 2:NAVAL HOSPITAL GREAT LAKES
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2833
Practice Address - Country:US
Practice Address - Phone:847-688-2616
Practice Address - Fax:847-688-2382
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2197152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist