Provider Demographics
NPI:1699064857
Name:WELKER, KATHERINE LOUISE (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:WELKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W POLK ST
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1917 W EVERGREEN AVE
Practice Address - Street 2:APT 3R
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4793
Practice Address - Country:US
Practice Address - Phone:619-201-3982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135583207PT0002X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology