Provider Demographics
NPI:1063579175
Name:KOSEK, SCOTT KIRBY (D C)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:KIRBY
Last Name:KOSEK
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:195 S. MARLEY ROAD
Mailing Address - Street 2:LINCOLN-WAY CHIROPRACTIC CLINIC, LTD
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451
Mailing Address - Country:US
Mailing Address - Phone:815-485-8200
Mailing Address - Fax:815-485-8996
Practice Address - Street 1:195 S. MARLEY ROAD
Practice Address - Street 2:LINCOLN-WAY CHIROPRACTIC CLINIC, LTD
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:815-485-8200
Practice Address - Fax:815-485-8996
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor