MEDICARE: DR. KATIE JEANNINE BURMEISTER 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
1	111N00000X	Chiropractor	038009763	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871585844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATIE JEANNINE BURMEISTER D.C.

Provider Business Mailing Address
First Line	:	PO BOX 86
Second Line	:
City	:	SALEM
State	:	IL
Zip	:	62881-0086
Country	:	US
Telephone Number	:	618-740-1711
Fax Number	:	618-662-4830

Provider Business Practice Location Address
First Line	:	120 S DELMAR AVE STE B
Second Line	:
City	:	SALEM
State	:	IL
Zip	:	62881-2000
Country	:	US
Telephone Number	:	618-401-7117
Fax Number	:	618-662-4830

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	01/12/2023

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