MEDICARE: KATIE DIANE KEELIN DC

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
1	111N00000X	Chiropractor	038.014083	IL

General Provider Information

NPI Number	:	1760250583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE DIANE KEELIN DC

Provider Business Mailing Address
First Line	:	13308 COMMONWEALTH DR
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-8503
Country	:	US
Telephone Number	:	952-431-7206
Fax Number	:

Provider Business Practice Location Address
First Line	:	3464 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1173
Country	:	US
Telephone Number	:	773-348-6908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	12/12/2023

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Directions to “ KATIE DIANE KEELIN DC” Practice Location

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