Provider Demographics
NPI:1255737037
Name:TRINQUERO, KATELYN NICOLE (MS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:NICOLE
Last Name:TRINQUERO
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:401 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4255
Mailing Address - Country:US
Mailing Address - Phone:513-253-2773
Mailing Address - Fax:
Practice Address - Street 1:401 N MICHIGAN AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4255
Practice Address - Country:US
Practice Address - Phone:513-253-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.005294363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant