Provider Demographics
NPI:1689951733
Name:KINETIC HEALTH LLC
Entity Type:Organization
Organization Name:KINETIC HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPIONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-393-0800
Mailing Address - Street 1:2 SOUTH 631 ROUTE 59
Mailing Address - Street 2:UNIT C
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555
Mailing Address - Country:US
Mailing Address - Phone:630-393-0800
Mailing Address - Fax:630-393-3880
Practice Address - Street 1:2 SOUTH 631 ROUTE 59
Practice Address - Street 2:UNIT C
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555
Practice Address - Country:US
Practice Address - Phone:630-393-0800
Practice Address - Fax:630-393-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011859305R00000X
IL038011687305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization