Provider Demographics
NPI:1578534186
Name:BURKE, KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:BURKE
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 1:3330 DUNDEE RD
Mailing Address - Street 2:SUITE C8
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2318
Mailing Address - Country:US
Mailing Address - Phone:847-480-1718
Mailing Address - Fax:847-480-1925
Practice Address - Street 1:3330 DUNDEE RD
Practice Address - Street 2:SUITE C8
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2318
Practice Address - Country:US
Practice Address - Phone:847-480-1718
Practice Address - Fax:847-480-1925
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0380104468111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212831Medicare ID - Type Unspecified