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General NPI Number Information
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NPI Number | 1609649474
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Entity Type | Organization
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Legal Business Name | DKRF INC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 308 W ERIE ST STE 100
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City | CHICAGO
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State | IL
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Zip | 60654-3914
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Country | US
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Telephone | 708-945-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 W 14TH PL UNIT 109
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City | CHICAGO
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State | IL
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Zip | 60608-2796
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | KATIE FORTMAN
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Credential | DC
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Telephone | 312-248-3076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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