=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699535419
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE QUIROZ-ESPARZA DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2024
-----------------------------------------------------
Last Update Date | 03/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28379 DAVIS PKWY STE 803
-----------------------------------------------------
City | WARRENVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60555-3032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-393-2225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1080 REDONDO DR
-----------------------------------------------------
City | ROMEOVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60446-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-430-9361
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 038.014055
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------