Provider Demographics
NPI:1750321642
Name:BUCKROP, KARLA SUE (DC CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:SUE
Last Name:BUCKROP
Suffix:
Gender:F
Credentials:DC CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 4TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:IL
Mailing Address - Zip Code:61264-2455
Mailing Address - Country:US
Mailing Address - Phone:309-787-3443
Mailing Address - Fax:
Practice Address - Street 1:331 4TH STREET WEST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:IL
Practice Address - Zip Code:61264-2455
Practice Address - Country:US
Practice Address - Phone:309-787-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038004750Medicaid
T38560Medicare UPIN
IL753900Medicare Oscar/Certification
IL038004750Medicaid