Provider Demographics
NPI:1235450313
Name:WUEBBELS, JANA RAE (DC)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:RAE
Last Name:WUEBBELS
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 1:401 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAMIANSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62215-1309
Mailing Address - Country:US
Mailing Address - Phone:618-570-9640
Mailing Address - Fax:
Practice Address - Street 1:971 EULA MAE PKWY
Practice Address - Street 2:
Practice Address - City:CARLYLE
Practice Address - State:IL
Practice Address - Zip Code:62231-6400
Practice Address - Country:US
Practice Address - Phone:618-594-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-12
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor