Coshun Baskin, DC
Individual provider Active NPI Chiropractor · Matteson, IL
NPI 1659563294 · NPPES record last updated Aug 17, 2007
Key facts
- NPI
- 1659563294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 3610 W. 212TH Place
Matteson, IL 60443 - Phone
- (708) 466-5535
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038010990 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
3610 W. 212TH Place
Matteson, IL 60443
Mailing address
3610 W. 212TH Place
Matteson, IL 60443
Phone (708) 466-5535
Other providers in Matteson, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2007. 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.