Healthcare Provider Details

I. General information

NPI: 1730097239
Provider Name (Legal Business Name): KATRINA WESTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 31ST ST STE 105
DOWNERS GROVE IL
60515-5535
US

IV. Provider business mailing address

1631 WESTCHESTER BLVD
WESTCHESTER IL
60154-4331
US

V. Phone/Fax

Practice location:
  • Phone: 630-206-0272
  • Fax:
Mailing address:
  • Phone: 630-206-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: