Provider Demographics
NPI:1407184146
Name:BIRKS, KARA M (DC)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:M
Last Name:BIRKS
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 1:810 S CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-1804
Mailing Address - Country:US
Mailing Address - Phone:563-210-7550
Mailing Address - Fax:
Practice Address - Street 1:810 S CHICAGO ST
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-1804
Practice Address - Country:US
Practice Address - Phone:563-210-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011838111N00000X
IA007253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor