Provider Demographics
NPI:1124271655
Name:STEGMAIER, JACOB WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:WILLIAM
Last Name:STEGMAIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 N GALENA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-1568
Mailing Address - Country:US
Mailing Address - Phone:815-285-2273
Mailing Address - Fax:815-285-2276
Practice Address - Street 1:841 N GALENA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-1568
Practice Address - Country:US
Practice Address - Phone:815-285-2273
Practice Address - Fax:815-285-2276
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor