MEDICARE: DR. JODI E PERRIN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	038010231	IL
2	111NI0900X	Internist Chiropractor	038010231	IL
3	111NP0017X	Pediatric Chiropractor	038010231	IL
4	111N00000X	Chiropractor	038010231	IL

General Provider Information

NPI Number	:	1194709261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODI E PERRIN DC

Provider Business Mailing Address
First Line	:	217 LONG AVE
Second Line	:
City	:	N. AURORA
State	:	IL
Zip	:	60542
Country	:	US
Telephone Number	:	630-618-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 LONG AVE
Second Line	:
City	:	N. AURORA
State	:	IL
Zip	:	60542
Country	:	US
Telephone Number	:	630-618-8559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	05/15/2019

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