Healthcare Provider Details

I. General information

NPI: 1497978480
Provider Name (Legal Business Name): WALTON CS-XI P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1852 COPPERFIELD DR
MORTON IL
61550-3169
US

IV. Provider business mailing address

1852 COPPERFIELD DR
MORTON IL
61550-3169
US

V. Phone/Fax

Practice location:
  • Phone: 309-338-4299
  • Fax:
Mailing address:
  • Phone: 309-338-4299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.009708
License Number StateIL

VIII. Authorized Official

Name: DR. JENNIFER CHRISTINE DANIEL-PRICE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 309-338-4299