Healthcare Provider Details

I. General information

NPI: 1841303815
Provider Name (Legal Business Name): SARAH ALEENE KEUSS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6818 W BELMONT AVE
CHICAGO IL
60634-4645
US

IV. Provider business mailing address

6818 W BELMONT AVE
CHICAGO IL
60634-4645
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-4529
  • Fax:
Mailing address:
  • Phone: 773-282-4529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-010420
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: