Individual ProviderKathleen A WardRadiologyAllopathic & Osteopathic PhysiciansPractice Address2160 S First Ave, (Mcgaw Ent., Rm. 47), Maywood, IL 60153(708) 216-5221PECOS EnrollmentThis provider is enrolled in PECOS as KATHLEEN WARD.Based on the most recent information from CMS, provider Kathleen A Ward is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1336126218Provider TypeIndividualFull NameWard, Kathleen ACredentialMDGenderFemaleSole ProprietorNoEnumeration Date12/30/2005Last Updated3/5/2010Contact InformationPractice LocationPractice Address2160 S First Ave, (Mcgaw Ent., Rm. 47), Maywood, IL 60153Phone(708) 216-5221Fax(708) 216-0899Mailing LocationMailing Address2160 S First Ave, (Mcgaw Ent., Rm. 47), Maywood, IL 60153Phone(708) 216-5221Fax(708) 216-0899Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense36064863IllinoisProvider IdentifiersIDDescriptionIssuerID36064863DescriptionMedicaidIssuerUnlistedIllinois