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General NPI Number Information
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NPI Number | 1659865848
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Entity Type | Organization
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Legal Business Name | NJL CHIROPRACTIC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 813 1ST AVE
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City | SILVIS
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State | IL
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Zip | 61282
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Country | US
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Telephone | 309-755-5203
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Fax | 309-755-5285
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Provider Business Mailing Address
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Address Line | 813 1ST AVE
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City | SILVIS
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State | IL
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Zip | 61282-1044
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Country | US
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Telephone | 309-755-5203
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Fax | 309-755-5285
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOHN CHRISTOPHER LEMKE
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Credential | DC
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Telephone | 309-755-5203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 060-004618
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License Number State | IL
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