Provider Demographics
NPI:1245318161
Name:OZTEKIN, KEVIN JOHN (DC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:JOHN
Last Name:OZTEKIN
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 1:301 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6089
Mailing Address - Country:US
Mailing Address - Phone:847-708-6600
Mailing Address - Fax:866-652-4523
Practice Address - Street 1:301 E RAND RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6089
Practice Address - Country:US
Practice Address - Phone:847-708-6600
Practice Address - Fax:866-652-4523
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK52549Medicare PIN