Provider Demographics
NPI:1295910354
Name:KING, KATIE S (DC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:S
Last Name:KING
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 1:190 WINDING CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5030
Mailing Address - Country:US
Mailing Address - Phone:708-955-1884
Mailing Address - Fax:
Practice Address - Street 1:600 SPRING HILL RING RD STE 111
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-7301
Practice Address - Country:US
Practice Address - Phone:847-915-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor