Healthcare Provider Details

I. General information

NPI: 1356438022
Provider Name (Legal Business Name): JEFFREY RANDALL CATES D.C., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N. 6TH ST.
OREGON IL
61061-1304
US

IV. Provider business mailing address

200 N. 6TH ST.
OREGON IL
61061-1304
US

V. Phone/Fax

Practice location:
  • Phone: 815-732-3753
  • Fax:
Mailing address:
  • Phone: 815-732-3753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: