Provider Demographics
NPI:1225367311
Name:BITLER, JAQUELYN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAQUELYN
Middle Name:
Last Name:BITLER
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 1:800 S WELLS ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 S WELLS ST
Practice Address - Street 2:SUITE 150
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4529
Practice Address - Country:US
Practice Address - Phone:312-765-0411
Practice Address - Fax:312-765-0585
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor