Provider Demographics
NPI:1699951137
Name:KABAKER, KATHERINE B (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:B
Last Name:KABAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:BUESCHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1753 W CONGRESS PKWY
Mailing Address - Street 2:JONES BLDG SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3838
Mailing Address - Country:US
Mailing Address - Phone:312-942-6600
Mailing Address - Fax:
Practice Address - Street 1:1753 W CONGRESS PKWY
Practice Address - Street 2:JONES BLDG SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3838
Practice Address - Country:US
Practice Address - Phone:312-942-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-049832207R00000X
IL036-121284207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine