Healthcare Provider Details

I. General information

NPI: 1083815633
Provider Name (Legal Business Name): MAUREEN F. KREUSER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1344 W ARTHUR AVE
CHICAGO IL
60626-5170
US

IV. Provider business mailing address

1344 W ARTHUR AVE
CHICAGO IL
60626-5170
US

V. Phone/Fax

Practice location:
  • Phone: 773-761-2383
  • Fax: 773-743-7152
Mailing address:
  • Phone: 773-761-2383
  • Fax: 773-743-7152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-006895
License Number StateIL

VIII. Authorized Official

Name: DR. MAUREEN FRANCES KREUSER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 773-761-2383