Provider Demographics
NPI:1083623946
Name:GRIFFITH, JENNIFER C (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 OLDE HALF DAY RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3061
Mailing Address - Country:US
Mailing Address - Phone:847-777-6900
Mailing Address - Fax:847-777-6901
Practice Address - Street 1:175 OLDE HALF DAY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3061
Practice Address - Country:US
Practice Address - Phone:847-777-6900
Practice Address - Fax:847-777-6901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor