Healthcare Provider Details

I. General information

NPI: 1912281395
Provider Name (Legal Business Name): KATHERINE OCONNOR DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE WEESSIES DC

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 W COLLEGE DR STE C
PALOS HEIGHTS IL
60463-1175
US

IV. Provider business mailing address

2625 BUTTERFIELD RD STE 301N
OAK BROOK IL
60523-1234
US

V. Phone/Fax

Practice location:
  • Phone: 708-274-4139
  • Fax: 708-274-4102
Mailing address:
  • Phone: 630-320-6400
  • Fax: 630-701-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-011954
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: