Provider Demographics
NPI:1447557533
Name:KANE, JESSA LYNN (DC)
Entity Type:Individual
Prefix:MS
First Name:JESSA
Middle Name:LYNN
Last Name:KANE
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 1:2021 MIDWEST RD
Mailing Address - Street 2:100E
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1342
Mailing Address - Country:US
Mailing Address - Phone:630-568-5942
Mailing Address - Fax:630-506-8272
Practice Address - Street 1:2021 MIDWEST RD
Practice Address - Street 2:100E
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1342
Practice Address - Country:US
Practice Address - Phone:630-568-5942
Practice Address - Fax:630-506-8272
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012851111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111N00000XChiropractic ProvidersChiropractor