Healthcare Provider Details

I. General information

NPI: 1407821390
Provider Name (Legal Business Name): KATHLEEN MARGARET LINDSEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28070 RT 176
ISLAND LAKE IL
60042-0120
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:
Title or Position:
Credential:
Phone: