Provider Demographics
NPI:1053029637
Name:MORITZ, KATRINA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:MARIE
Last Name:MORITZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KATRINA
Other - Middle Name:MARIE
Other - Last Name:KRUTZIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2640 PATRIOT BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8075
Mailing Address - Country:US
Mailing Address - Phone:224-616-3002
Mailing Address - Fax:866-738-9555
Practice Address - Street 1:2640 PATRIOT BLVD STE 220
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8075
Practice Address - Country:US
Practice Address - Phone:224-616-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor