Bottum, Kathleen M
Bottum, Kathleen M is an individual health care provider with primary practice located at 751 N Rutledge St Ste 1700 , Springfield IL 62702. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Psychosomatic Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Bottum, Kathleen M can be contacted via phone (217) 545-8000.Contact Information
Primary practice address
751 N Rutledge St Ste 1700
Springfield IL 62702
Phone: (217) 545-8000
Fax: (217) 545-8163
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-106435 | Illinois |
| Allopathic & Osteopathic Physicians / Psychosomatic Medicine | 2084P0015X | 036-106742 | Illinois |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 036-106742 | Illinois |
Profile Details
| NPI number | 1124003025 |
|---|---|
| LBN Legal business name | Bottum, Kathleen M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2005 |
| Last updated | Oct 20th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124003025 | NPPES |
| Illinois | MEDICAID | 036106435 |
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