Healthcare Provider Details

I. General information

NPI: 1164599775
Provider Name (Legal Business Name): KOREN JEAN DUHR D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HERITAGE DR STE 3
CRYSTAL LAKE IL
60014-8059
US

IV. Provider business mailing address

2783 SORREL ROW
LAKE IN THE HILLS IL
60156-6703
US

V. Phone/Fax

Practice location:
  • Phone: 815-404-3670
  • Fax:
Mailing address:
  • Phone: 815-404-3670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number038-009417
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: