Provider Demographics
NPI:1316500804
Name:KATZMAN, CAROLINE LILI (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:LILI
Last Name:KATZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-747-3000
Mailing Address - Fax:314-996-3230
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM GENERAL MED, STE 12B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-747-3000
Practice Address - Fax:314-996-3230
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025034655207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200163585Medicaid