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NPI Code Detail

MEDICARE: DR. JACK D. KEYSER D.C

MEDICARE:  DR. JACK D. KEYSER  D.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NR0400XRehabilitation ChiropractorIL

General Provider Information

NPI Number : 1255495818
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACK D. KEYSER D.C
Provider Business Mailing Address
First Line : 1935 S PLUM GROVE RD # 363
Second Line :
City : PALATINE
State : IL
Zip : 60067-7258
Country : US
Telephone Number : 847-397-6975
Fax Number :
Provider Business Practice Location Address
First Line : 504 N PLUM GROVE RD
Second Line :
City : PALATINE
State : IL
Zip : 60067-8207
Country : US
Telephone Number : 847-934-3738
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JACK D. KEYSER D.C” Practice Location

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