Provider Demographics
NPI:1831259639
Name:WILHELMI, KEVIN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:WILHELMI
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 1:3706 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1237
Mailing Address - Country:US
Mailing Address - Phone:612-822-7509
Mailing Address - Fax:612-827-3860
Practice Address - Street 1:3706 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1237
Practice Address - Country:US
Practice Address - Phone:612-822-7509
Practice Address - Fax:612-827-3860
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN252872OtherMIDLANDS CHOICE
MN155L8LIOtherBCBS GROUP NUMBER
MN291K0WIOtherBLUE CROSS BLUE SHIELD
MN323650100Medicaid
MN291K0WIOtherBLUE CROSS BLUE SHIELD
MN323650100Medicaid