Physician Compare National (NPI:1902971575)

HEALTHCARE PROVIDER: JERRY LYNN FELTS DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902971575
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810045697
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090505000312
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FELTS
	Individual professional last name
Provider First Name	JERRY
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOGAN COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1508 SIOUX DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	MARION
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	629595200
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6189932810
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y