Provider Demographics
NPI:1871081679
Name:KUNEVICH, CATHERINE EDITH (DC)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:EDITH
Last Name:KUNEVICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:KERPERIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:724 LUNCH RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62285-2544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:IL
Practice Address - Zip Code:62285-1705
Practice Address - Country:US
Practice Address - Phone:618-520-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor