Healthcare Provider Details

I. General information

NPI: 1255465522
Provider Name (Legal Business Name): LINDSEY CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28070 RT. 176
ISLAND LAKE IL
60042-9551
US

IV. Provider business mailing address

PO BOX 120
ISLAND LAKE IL
60042-0120
US

V. Phone/Fax

Practice location:
  • Phone: 847-487-1111
  • Fax: 847-487-1164
Mailing address:
  • Phone: 847-487-1111
  • Fax: 847-487-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038006442
License Number StateIL

VIII. Authorized Official

Name: DR. KATHLEEN MARGARET LINDSEY
Title or Position: PRESIDENT
Credential: DC
Phone: 847-487-1111