Provider Demographics
NPI:1033307244
Name:STEVEN G. KEHRES, D.C.,S.C.
Entity Type:Organization
Organization Name:STEVEN G. KEHRES, D.C.,S.C.
Other - Org Name:FAMILY CHIROPRACTIC AND ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:KEHRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-223-1220
Mailing Address - Street 1:968 E ROLLINS RD
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-2247
Mailing Address - Country:US
Mailing Address - Phone:847-223-1220
Mailing Address - Fax:847-223-1271
Practice Address - Street 1:968 E ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-2247
Practice Address - Country:US
Practice Address - Phone:847-223-1220
Practice Address - Fax:847-223-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL973600Medicare UPIN