Individual provider Active NPI

Beth Kathan

  • Acupuncturist
  • Lisle, IL
National Provider Identifier
1104474212
Registry record updated Sep 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198001464 Issued in IL
Practice address
4300 Commerce CT Ste 318
Lisle, IL 60532-3698
Phone
(630) 686-2626
NPI assigned
Sep 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198001464 IL Primary

Addresses

Primary practice location

4300 Commerce CT Ste 318
Lisle, IL 60532-3698

Mailing address

5747 W Warwick Ave
Chicago, IL 60634-2658
Phone (773) 610-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
198001464ILMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Peak Acupuncturist CurrentSince Sep 8, 2019 Accepting new patients

Locations

4300 Commerce Ct
Ste 318
Lisle, IL 60532
Phone (331) 701-7930

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567296000000",
    "number": "1104474212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 W WARWICK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342658",
            "telephone_number": "773-610-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 COMMERCE CT STE 318",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323698",
            "telephone_number": "630-686-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHAN",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-01",
        "last_updated": "2019-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198001464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.