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General NPI Number Information
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NPI Number | 1710024054
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Entity Type | Individual
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Provider Name | JONATHAN ALLEN HAIGH D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3900 WASHINGTON ST STE I
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City | GURNEE
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State | IL
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Zip | 60031-5715
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Country | US
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Telephone | 847-782-9280
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Fax | 847-782-9285
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Provider Business Mailing Address
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Address Line | 4625 SAINT REGIS DR
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City | RACINE
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State | WI
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Zip | 53403-3988
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Country | US
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Telephone | 262-554-1978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 038-01029
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0004070-012
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License Number State | WI
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