Provider Demographics
NPI:1689883480
Name:1ST PLACE CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:1ST PLACE CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-584-5200
Mailing Address - Street 1:1750 E MAIN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2363
Mailing Address - Country:US
Mailing Address - Phone:630-584-5200
Mailing Address - Fax:630-584-8370
Practice Address - Street 1:1750 E MAIN ST
Practice Address - Street 2:SUITE 140
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2363
Practice Address - Country:US
Practice Address - Phone:630-584-5200
Practice Address - Fax:630-584-8370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty