| Street | 2061 W Maple Ave | ||
| City/Town | Mundelein | ||
| State/Province/Region | Illinois | ||
| Zip/Postal Code | 60060 | ||
| Phone Number | (847) 949-0858 | ||
| Country | United States |
| Full Name | Karli Effertz MD | ||
| Gender | female | ||
| Birthday | 1991-01-10 | ||
| Social Security Number | 251-99-1976 |
| Credit card brand | American Express | ||
| Credit card number | 344440520885768 | ||
| Expire | 2028/1 | ||
| CVV | 235 |