Provider Demographics
NPI:1164599775
Name:DUHR, KOREN JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KOREN
Middle Name:JEAN
Last Name:DUHR
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 1:2783 SORREL ROW
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6703
Mailing Address - Country:US
Mailing Address - Phone:815-404-3670
Mailing Address - Fax:
Practice Address - Street 1:185 HERITAGE DR STE 3
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8059
Practice Address - Country:US
Practice Address - Phone:815-404-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009417111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05632158OtherBLUE CROSS BLUE SHIELD
IL05632158OtherBLUE CROSS BLUE SHIELD