Provider Demographics
NPI:1326203787
Name:O'HARA, KEVIN TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:TIMOTHY
Last Name:O'HARA
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 1:215 S NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-8300
Mailing Address - Country:US
Mailing Address - Phone:847-842-8070
Mailing Address - Fax:847-382-1540
Practice Address - Street 1:215 S NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-8300
Practice Address - Country:US
Practice Address - Phone:847-842-8070
Practice Address - Fax:847-382-1540
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor