Provider Demographics
NPI:1225285638
Name:VILLARREAL, OKI KIM (DC, BSEE)
Entity Type:Individual
Prefix:MS
First Name:OKI
Middle Name:KIM
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:DC, BSEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 AUDUBON LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-8853
Mailing Address - Country:US
Mailing Address - Phone:815-230-0847
Mailing Address - Fax:
Practice Address - Street 1:1695 N FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1509
Practice Address - Country:US
Practice Address - Phone:630-898-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0380112233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor