Organization
KIRK CENTER FOR HEALTHY LIVING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI DAWN KIRK PT (PHYSICAL THERAPIST PRESIDENT)
(708) 301-3102
Entity
Organization
Contact information
Practice address
14815 FOUNDERS XING, HOMER GLEN, IL 60491-6705
(708) 301-3102
(708) 301-4450
Mailing address
14815 FOUNDERS XING, HOMER GLEN, IL 60491-6705
(708) 301-3102
(708) 301-4450
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932478
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/01/2006
Last updated
12/07/2007
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