Provider Demographics
NPI:1548495344
Name:KIJINSKI, KRISTY ANN (DC)
Entity type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:ANN
Last Name:KIJINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 N WEBER RD
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-3972
Mailing Address - Country:US
Mailing Address - Phone:815-293-3000
Mailing Address - Fax:
Practice Address - Street 1:417 N WEBER RD
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-3972
Practice Address - Country:US
Practice Address - Phone:815-293-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor