Kevin Paul Shimer
Individual provider Active NPI Chiropractor · Elburn, IL
NPI 1154817328 · NPPES record last updated Jul 10, 2018
Key facts
- NPI
- 1154817328
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038013239 (IL)
- Practice address
- 701 E North St Ste B
Elburn, IL 60119-9052 - Phone
- (630) 365-5820
- Fax
- (630) 365-5815
- NPI assigned
- Jul 10, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038013239 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trillium Health & Wellness, SC | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038013239 | IL | Yes |
Addresses
Primary practice location
701 E North St Ste B
Elburn, IL 60119-9052
Mailing address
701 E North St Ste B
Elburn, IL 60119-9052
Phone (630) 365-5820
Other providers in Elburn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.