Provider Demographics
NPI:1841643368
Name:JONES CHIROPRACTIC SC
Entity type:Organization
Organization Name:JONES CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-483-2207
Mailing Address - Street 1:1209 N MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-8102
Mailing Address - Country:US
Mailing Address - Phone:217-483-2207
Mailing Address - Fax:217-483-3248
Practice Address - Street 1:1209 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHATHAM
Practice Address - State:IL
Practice Address - Zip Code:62629-8102
Practice Address - Country:US
Practice Address - Phone:217-483-2207
Practice Address - Fax:217-483-3248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty