Provider Demographics
NPI:1407821390
Name:LINDSEY, KATHLEEN MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARGARET
Last Name:LINDSEY
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:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:ISLAND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60042-0120
Mailing Address - Country:US
Mailing Address - Phone:847-487-1111
Mailing Address - Fax:847-487-1164
Practice Address - Street 1:28070 RT 176
Practice Address - Street 2:
Practice Address - City:ISLAND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60042-0120
Practice Address - Country:US
Practice Address - Phone:847-487-1111
Practice Address - Fax:847-487-1164
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL916110Medicare ID - Type Unspecified
ILIL7288001Medicare PIN
ILT91222Medicare UPIN