Provider Demographics
NPI:1891088936
Name:GOERSCHLER, KYLE S (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:S
Last Name:GOERSCHLER
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 1:1821 HICKS RD
Mailing Address - Street 2:STE B
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1274
Mailing Address - Country:US
Mailing Address - Phone:847-951-9307
Mailing Address - Fax:
Practice Address - Street 1:154 TIMBER TRAILS BLVD
Practice Address - Street 2:
Practice Address - City:GILBERTS
Practice Address - State:IL
Practice Address - Zip Code:60136-4058
Practice Address - Country:US
Practice Address - Phone:847-951-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor