Provider Demographics
NPI:1013082775
Name:DZEKUNSKAS, KAREN R (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:R
Last Name:DZEKUNSKAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:R
Other - Last Name:DZEKUNSKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1005 PEORIA STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:IL
Mailing Address - Zip Code:62656-2157
Mailing Address - Country:US
Mailing Address - Phone:217-732-8606
Mailing Address - Fax:217-735-1663
Practice Address - Street 1:1005 PEORIA STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-2157
Practice Address - Country:US
Practice Address - Phone:217-732-8606
Practice Address - Fax:217-735-1663
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05482010OtherBCBS
IL05482010OtherBCBS
985590Medicare ID - Type Unspecified