Healthcare Provider Details

I. General information

NPI: 1346842598
Provider Name (Legal Business Name): DR. JASON WINKELMANN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 MADISON ST
OAK PARK IL
60302-4435
US

IV. Provider business mailing address

501 MADISON ST APT B
OAK PARK IL
60302-4406
US

V. Phone/Fax

Practice location:
  • Phone: 847-814-2096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON WINKELMANN
Title or Position: OWNER
Credential: ND, DC
Phone: 847-814-2096