Provider Demographics
NPI:1306420856
Name:KINDER, MORGAN MAVE (DC)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:MAVE
Last Name:KINDER
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 1:721 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62014-1503
Mailing Address - Country:US
Mailing Address - Phone:618-585-3522
Mailing Address - Fax:618-585-3523
Practice Address - Street 1:721 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IL
Practice Address - Zip Code:62014-1503
Practice Address - Country:US
Practice Address - Phone:618-585-3522
Practice Address - Fax:618-585-3523
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor