Provider Demographics
NPI:1548226194
Name:GOYKE, KEVIN ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALLEN
Last Name:GOYKE
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 1:2401 KANEVILLE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2577
Mailing Address - Country:US
Mailing Address - Phone:630-715-1183
Mailing Address - Fax:
Practice Address - Street 1:2401 KANEVILLE RD STE 3
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2577
Practice Address - Country:US
Practice Address - Phone:630-715-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4508648OtherBLUE CROSS BLUE SHIELD
IL4508648OtherBLUE CROSS BLUE SHIELD
ILU54718Medicare UPIN