Provider Demographics
NPI:1861745010
Name:NORMAN, KIM HEPWORTH (DC)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:HEPWORTH
Last Name:NORMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:HEPWORTH
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:343 DIANE CT
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4649
Mailing Address - Country:US
Mailing Address - Phone:630-940-8001
Mailing Address - Fax:
Practice Address - Street 1:2401 KANEVILLE RD STE 3
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2577
Practice Address - Country:US
Practice Address - Phone:630-940-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007172111N00000X
CADC25701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor