Provider Demographics
NPI:1255348116
Name:MULHALL, CAROLINE (DC)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:MULHALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CARIE
Other - Middle Name:
Other - Last Name:MULHALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:9025 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1458
Mailing Address - Country:US
Mailing Address - Phone:708-598-9003
Mailing Address - Fax:708-598-9004
Practice Address - Street 1:9025 NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-1458
Practice Address - Country:US
Practice Address - Phone:708-598-9003
Practice Address - Fax:708-598-9004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210431Medicare ID - Type Unspecified