Provider Demographics
NPI:1760909675
Name:KALAPP, INC
Entity Type:Organization
Organization Name:KALAPP, INC
Other - Org Name:ACTIVE LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KEANE
Authorized Official - Last Name:KALAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-223-0988
Mailing Address - Street 1:2426 CHARTRES ST
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-1107
Mailing Address - Country:US
Mailing Address - Phone:815-223-0988
Mailing Address - Fax:
Practice Address - Street 1:2426 CHARTRES ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-1107
Practice Address - Country:US
Practice Address - Phone:815-223-0988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1184782294Medicaid