Provider Demographics
NPI:1205823119
Name:KAHON, JAMIE LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LYNNE
Last Name:KAHON
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 1:601 W CENTRAL RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2379
Mailing Address - Country:US
Mailing Address - Phone:847-259-6605
Mailing Address - Fax:847-259-8071
Practice Address - Street 1:601 W CENTRAL RD
Practice Address - Street 2:SUITE 5
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2379
Practice Address - Country:US
Practice Address - Phone:847-259-6605
Practice Address - Fax:847-259-8071
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL200434Medicare ID - Type Unspecified
ILU88230Medicare UPIN