Provider Demographics
NPI:1114972189
Name:FERSTL CHIROPRACTIC CLINIC P.C.
Entity Type:Organization
Organization Name:FERSTL CHIROPRACTIC CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:FERSTL
Authorized Official - Suffix:
Authorized Official - Credentials:DC DABCO
Authorized Official - Phone:847-363-4667
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 1:958 BRANDON CT
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-2001
Practice Address - Country:US
Practice Address - Phone:847-363-4667
Practice Address - Fax:847-402-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004455111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213361Medicare ID - Type Unspecified
ILT37799Medicare UPIN