Healthcare Provider Details

I. General information

NPI: 1770676579
Provider Name (Legal Business Name): MAUREEN FRANCES KREUSER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/01/2011
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:
Title or Position:
Credential:
Phone: