Provider Demographics
NPI:1336925569
Name:D'AMICO, KENNEDI (DC)
Entity type:Individual
Prefix:
First Name:KENNEDI
Middle Name:
Last Name:D'AMICO
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W HIGGINS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9388
Mailing Address - Country:US
Mailing Address - Phone:847-426-7008
Mailing Address - Fax:
Practice Address - Street 1:33 W HIGGINS RD STE 520
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9388
Practice Address - Country:US
Practice Address - Phone:847-426-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.014043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor