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General NPI Number Information
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NPI Number | 1699032557
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Entity Type | Organization
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Legal Business Name | JEANETTE K. FEFLES LTD.
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 12/26/2017
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Provider Practice Location Address
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Address Line | 12505 S RIDGELAND AVE STE 2
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1867
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Country | US
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Telephone | 708-671-1444
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Fax | 708-671-1433
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Provider Business Mailing Address
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Address Line | 12505 S RIDGELAND AVE STE 2
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1867
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Country | US
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Telephone | 708-671-1444
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Fax | 708-671-1433
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Authorized Official
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Title or Position | OWNER
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Name | JEANETTE K. FEFLES
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Credential | DC
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Telephone | 708-671-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.009574
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License Number State | IL
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