Healthcare Provider Details

I. General information

NPI: 1982517306
Provider Name (Legal Business Name): CAROLINA ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 W 35TH ST
CHICAGO IL
60609-1309
US

IV. Provider business mailing address

4602 S ALBANY AVE # 1R
CHICAGO IL
60632-2534
US

V. Phone/Fax

Practice location:
  • Phone: 773-456-2017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149019221
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: