Healthcare Provider Details

I. General information

NPI: 1134978554
Provider Name (Legal Business Name): KAREN CHRISTINE QUIRARTE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 N ABERDEEN ST APT 1207
CHICAGO IL
60607-3236
US

IV. Provider business mailing address

3333 GREEN BAY RD
NORTH CHICAGO IL
60064-3037
US

V. Phone/Fax

Practice location:
  • Phone: 310-493-9736
  • Fax:
Mailing address:
  • Phone: 847-578-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085-010700
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: