Provider Demographics
NPI:1063408763
Name:CAHILL, SAMSON KEEFE (DC)
Entity type:Individual
Prefix:
First Name:SAMSON
Middle Name:KEEFE
Last Name:CAHILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S WOLF RD
Mailing Address - Street 2:UNIT 206
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:630-290-7269
Mailing Address - Fax:
Practice Address - Street 1:1919 S WOLF RD
Practice Address - Street 2:UNIT 206
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2163
Practice Address - Country:US
Practice Address - Phone:630-290-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor