Kathi Lyne Bliler, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-000454 Issued in IL

Practice address

650 Dakota St
Suite a
Crystal Lake, IL 60012-3744

Phone

(815) 455-6000

Fax

(815) 356-1104

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kathi Lyne Ketterling Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1265543557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DAKOTA ST",
            "address_2": "SUITE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123744",
            "telephone_number": "815-455-6000",
            "fax_number": "815-356-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DAKOTA ST",
            "address_2": "SUITE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123744",
            "telephone_number": "815-455-6000",
            "fax_number": "815-356-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLILER",
        "first_name": "KATHI",
        "middle_name": "LYNE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-000454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHI",
            "last_name": "KETTERLING",
            "middle_name": "LYNE",
            "prefix": "MISS",
            "credential": "P.A-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Alexandra Blakewell
• Ruth A Blameuser, M.S. OT, OTR/L
• Tracey Blanchard
• Jordan Blochwitz, DMD
• Laura S Blumenkamp, PT
• Tessa Blumthal
• Summer Evalyn Schaal Bochat, DPM
• Susan Lynn Bockman, MSN, CNP

• Physician Assistant in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.