Provider Demographics
NPI:1174003511
Name:ALLIBONE, KEVIN DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DONALD
Last Name:ALLIBONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2777 FINLEY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1035
Mailing Address - Country:US
Mailing Address - Phone:630-656-1326
Mailing Address - Fax:630-656-1883
Practice Address - Street 1:2777 FINLEY RD STE 4
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1035
Practice Address - Country:US
Practice Address - Phone:630-656-1326
Practice Address - Fax:630-656-1883
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor