Provider Demographics
NPI:1386769610
Name:AMADOR, KIRK ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:ANTHONY
Last Name:AMADOR
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 1:920 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-1047
Mailing Address - Country:US
Mailing Address - Phone:309-792-6030
Mailing Address - Fax:309-792-6095
Practice Address - Street 1:920 1ST AVE
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-1047
Practice Address - Country:US
Practice Address - Phone:309-792-6030
Practice Address - Fax:309-792-6095
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL351820Medicaid