Provider Demographics
NPI:1174723985
Name:KERELIS, VILIJA R (DC)
Entity type:Individual
Prefix:DR
First Name:VILIJA
Middle Name:R
Last Name:KERELIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6420 W 127TH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2269
Mailing Address - Country:US
Mailing Address - Phone:708-239-0909
Mailing Address - Fax:708-239-0073
Practice Address - Street 1:6420 W 127TH ST
Practice Address - Street 2:SUITE 106
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2269
Practice Address - Country:US
Practice Address - Phone:708-239-0909
Practice Address - Fax:708-239-0073
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006084111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL778540Medicare PIN