Provider Demographics
NPI:1548370471
Name:TIMMER, CHRISTOPHER J (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:TIMMER
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 1:15203 W 87TH STREET PKWY
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1409
Mailing Address - Country:US
Mailing Address - Phone:913-307-0150
Mailing Address - Fax:913-599-1548
Practice Address - Street 1:15203 W 87TH STREET PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1409
Practice Address - Country:US
Practice Address - Phone:913-307-0150
Practice Address - Fax:913-599-1548
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSN840000OtherMEDICARE GROUP NUMBER
KS28235029OtherBCBS PROVIDER NUMBER
KS372575OtherBCBS STATE EMPLOYEES #
KSN84A918Medicare PIN
KSN840000OtherMEDICARE GROUP NUMBER