Provider Demographics
NPI:1922156165
Name:ALKA, KAY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:LYNN
Last Name:ALKA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-1551
Mailing Address - Country:US
Mailing Address - Phone:618-262-4994
Mailing Address - Fax:
Practice Address - Street 1:415 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-1551
Practice Address - Country:US
Practice Address - Phone:618-262-4994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9328304OtherBLUE CROSS BLUE SHIELD
IL209654Medicare PIN
ILU88231Medicare UPIN