MEDICARE: KARLA ESPINOSA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	041.310161	IL

General Provider Information

NPI Number	:	1194046383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA ESPINOSA RN

Provider Business Mailing Address
First Line	:	5300 N CHRISTIANA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-4710
Country	:	US
Telephone Number	:	773-516-4469
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 N CHRISTIANA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-4710
Country	:	US
Telephone Number	:	773-516-4469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/22/2010

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