Provider Demographics
NPI:1609391002
Name:PFAFFINGER, KATELYN NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:NICOLE
Last Name:PFAFFINGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 HALE ST
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IL
Mailing Address - Zip Code:60152-2346
Mailing Address - Country:US
Mailing Address - Phone:815-347-6893
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD STE 965
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2048
Practice Address - Country:US
Practice Address - Phone:847-466-5157
Practice Address - Fax:847-466-5764
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty