Provider Demographics
NPI:1821061946
Name:BIEBER, KEVIN M (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:BIEBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 N WEBER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4945
Mailing Address - Country:US
Mailing Address - Phone:815-372-0170
Mailing Address - Fax:815-372-0171
Practice Address - Street 1:432 N WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-4945
Practice Address - Country:US
Practice Address - Phone:815-372-0170
Practice Address - Fax:815-372-0171
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010028111N00000X
IAA5634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09821954OtherBCBS
IL038-01002801Medicaid
IL448520Medicare UPIN
ILF400220370Medicare PIN