Provider Demographics
NPI:1316380793
Name:BENHART-MARTEL, KRYSTY LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRYSTY
Middle Name:LYNNE
Last Name:BENHART-MARTEL
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 1:1304 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1714
Mailing Address - Country:US
Mailing Address - Phone:563-676-3806
Mailing Address - Fax:
Practice Address - Street 1:1304 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1714
Practice Address - Country:US
Practice Address - Phone:563-676-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor