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Individual

DR. COLLEEN ANNE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1141 55TH ST, DOWNERS GROVE, IL 60515-4812
(630) 963-5029
(630) 297-8372
Mailing address
1141 55TH ST, DOWNERS GROVE, IL 60515-4812
(630) 963-5029
(630) 297-8372

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038004218
IL
111NN1001X
Nutrition Chiropractor
038004218
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02215206
BCBS
IL
01
038004218
ILLINOIS LICENSE NUMBER
IL
Enumeration date
12/18/2006
Last updated
10/15/2023
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