Provider Demographics
NPI:1336896372
Name:KILPATRICK, CLAIRE EILEEN (CPO/L)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:EILEEN
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:CPO/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 N SHEFFIELD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5084
Mailing Address - Country:US
Mailing Address - Phone:773-472-3663
Mailing Address - Fax:773-472-3668
Practice Address - Street 1:2835 N SHEFFIELD AVE STE 301
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5084
Practice Address - Country:US
Practice Address - Phone:773-472-3663
Practice Address - Fax:773-472-3668
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213000413222Z00000X
IL211000366224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist