Provider Demographics
NPI:1306871298
Name:KUHLMAN, GREGORY T (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:T
Last Name:KUHLMAN
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 1:1 S VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-5826
Mailing Address - Country:US
Mailing Address - Phone:815-356-9371
Mailing Address - Fax:815-356-9428
Practice Address - Street 1:1 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-5826
Practice Address - Country:US
Practice Address - Phone:815-356-9371
Practice Address - Fax:815-356-9428
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05623778OtherBLUECROSS/BLUESHIELD
IL038008351Medicaid
IL05623778OtherBLUECROSS/BLUESHIELD
IL038008351Medicaid
P00469041Medicare PIN