Provider Demographics
NPI:1114269644
Name:JOSEPH, SIMONE JOANNE (DC)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:JOANNE
Last Name:JOSEPH
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 1:1515 N HARLEM AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1250
Mailing Address - Country:US
Mailing Address - Phone:708-848-2730
Mailing Address - Fax:708-848-2739
Practice Address - Street 1:1515 N HARLEM AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1250
Practice Address - Country:US
Practice Address - Phone:708-848-2730
Practice Address - Fax:708-848-2739
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor