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General NPI Number Information
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NPI Number | 1740646801
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Entity Type | Organization
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Legal Business Name | KINDRED CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 1811 W NORTH AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60622-1488
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Country | US
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Telephone | 872-802-4096
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 W NORTH AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60622-1488
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Country | US
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Telephone | 872-802-4096
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KATHLEEN ALEMAN
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Credential | D.C.
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Telephone | 872-802-4096
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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 | 038.012483
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License Number State | IL
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