Provider Demographics
NPI:1023015112
Name:STONEHOUSE, KARREN SUE (DC)
Entity Type:Individual
Prefix:MS
First Name:KARREN
Middle Name:SUE
Last Name:STONEHOUSE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-0004
Mailing Address - Country:US
Mailing Address - Phone:563-823-0386
Mailing Address - Fax:563-823-0651
Practice Address - Street 1:325 16TH ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4901
Practice Address - Country:US
Practice Address - Phone:563-823-0386
Practice Address - Fax:563-823-0651
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06737111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08127538OtherBC/BS IL
IA0451714Medicaid
IL704110Medicare ID - Type Unspecified
IL08127538OtherBC/BS IL