Katie Awad

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036137012 Issued in IL

Practice address

180 S 3Rd St Ste 400
Belleville, IL 62220-1952

Phone

(618) 233-7880

Fax

(618) 222-4792

NPI assigned

Jul 19, 2012

Last updated

Mar 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1902151483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST STE 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952",
            "telephone_number": "618-233-7880",
            "fax_number": "618-222-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST STE 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952",
            "telephone_number": "618-233-7880",
            "fax_number": "618-222-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAD",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.062461",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036137012",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036137012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.