Healthcare Provider Details

I. General information

NPI: 1083143275
Provider Name (Legal Business Name): KRISTEN RENEE ESQUIVEL SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN RENEE MCINTYRE

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W MULBERRY ST
WATSEKA IL
60970-1568
US

IV. Provider business mailing address

323 W MULBERRY ST
WATSEKA IL
60970
US

V. Phone/Fax

Practice location:
  • Phone: 815-432-5241
  • Fax: 815-432-4537
Mailing address:
  • Phone: 815-432-5241
  • Fax: 815-432-4537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: