Provider Demographics
NPI:1538839162
Name:IZADYAR, ELIKA (DC)
Entity type:Individual
Prefix:
First Name:ELIKA
Middle Name:
Last Name:IZADYAR
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 1:1010 CARONDELET DR STE 204
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4822
Mailing Address - Country:US
Mailing Address - Phone:816-384-2300
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DR STE 204
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4822
Practice Address - Country:US
Practice Address - Phone:816-384-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021036429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor