Provider Demographics
NPI:1316940430
Name:FERSTL, JOSEPH F (DC DABCO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:FERSTL
Suffix:
Gender:M
Credentials:DC DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 WEATHERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2019
Mailing Address - Country:US
Mailing Address - Phone:847-741-3355
Mailing Address - Fax:847-741-3597
Practice Address - Street 1:1557 WEATHERSTONE LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2019
Practice Address - Country:US
Practice Address - Phone:847-741-3355
Practice Address - Fax:847-741-3597
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004455111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04582056OtherBC/BS
IL681040Medicare ID - Type Unspecified
IL04582056OtherBC/BS