KATHLEEN M BOTTUM (NPI# 1124003025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124003025 |
| Entity Type | Individual |
| Full Name | KATHLEEN M BOTTUM |
| Credential | M.D. |
| Practice Address |
751 N Rutledge St Ste 1700 Springfield IL 62702 |
| Mailing Address |
Po Box 19642 Springfield IL 62794-9642 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175458163 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175458163 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036-106435 | IL | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036-106742 | IL | Allopathic & Osteopathic Physicians |
| N | 2084P0015X |
Psychiatry & Neurology Specialization: Psychosomatic Medicine |
036-106742 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036106435 | 05 |
| Street Address |
751 N RUTLEDGE ST STE 1700 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699251702 | Sarah M Goone | Nurse Practitioner | 751 N Rutledge St Ste 1700, Springfield, IL 62702 | 2018-07-12 |
| 1154831303 | Katherine L Sarsfield | Nurse Practitioner | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2017-10-02 |
| 1699207381 | Makarem Abulimon | Student in an Organized Health Care Education/Training Program | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2017-03-31 |
| 1467894527 | Sanober Parveen | Internal Medicine | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2013-07-17 |
| 1811338841 | Mariam Murtaza Ali | Internal Medicine | 751 N Rutledge St Ste 1700, Springfield, IL 62702-4968 | 2013-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076683 | Forefront-khatkhate Medical Services PC | Psychiatry & Neurology | 600 S 2nd St Ste 404, Springfield, IL 62704-2542 | 2019-08-01 |
| 1699043976 | Terry Arthur Travis | Psychiatry & Neurology | 1200 Ravenswood, Na, Springfield, IL 62711-6079 | 2011-12-01 |
| 1659512184 | Julie A. Warren, Md LLC | Psychiatry & Neurology | 1911 S. National Avenue, Suite 405, Springfield, MO 65804 | 2009-03-12 |
| 1255577821 | William Basham | Psychiatry & Neurology | 5729 Main St # 330, Springfield, OR 97478-5426 | 2009-01-01 |
| 1679718043 | Leslie Jeanne Phelps | Psychiatry & Neurology | 1717 E. Primrose St., Apartment B204, Springfield, MO 65804-5413 | 2008-12-12 |
| 1134302656 | Interlink Behavioral Services, P.C. | Psychiatry & Neurology | 3121 S Terrace Green Ct, Springfield, MO 65804-4555 | 2007-12-06 |
| 1366621351 | Azra A Farooqui | Psychiatry & Neurology | 7745 Jewelweed Ct, Springfield, VA 22152-3148 | 2007-10-26 |
| 1093919714 | Lillian Joy Houston | Psychiatry & Neurology | 315 W Carpenter St Dept Of, Springfield, IL 62702-4901 | 2007-06-14 |
| 1881808145 | Yakhmi Mds | Psychiatry & Neurology | 1505 N Limestone St, Springfield, OH 45503-3317 | 2007-05-09 |
| 1588784706 | Asad Gobar | Psychiatry & Neurology | 5922 Hall St, Springfield, VA 22152-1401 | 2007-03-30 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.