Provider Demographics
NPI:1902661143
Name:KIXMILLER, ALEX RAE (DC)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:RAE
Last Name:KIXMILLER
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 1:15114 W QUINCY CIR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-9171
Mailing Address - Country:US
Mailing Address - Phone:812-893-0540
Mailing Address - Fax:
Practice Address - Street 1:205 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1856
Practice Address - Country:US
Practice Address - Phone:815-462-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.014129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor