Provider Demographics
NPI:1841303815
Name:KEUSS, SARAH ALEENE (DC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALEENE
Last Name:KEUSS
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 1:6818 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4645
Mailing Address - Country:US
Mailing Address - Phone:773-282-4529
Mailing Address - Fax:
Practice Address - Street 1:6818 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4645
Practice Address - Country:US
Practice Address - Phone:773-282-4529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635345OtherBCBS PROVIDER NUMBER
IL1635345OtherBCBS PROVIDER NUMBER