Provider Demographics
NPI:1235550641
Name:EWERS, JENNA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:ANN
Last Name:EWERS
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 1:852 SHARP DR
Mailing Address - Street 2:UNIT J
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-8843
Mailing Address - Country:US
Mailing Address - Phone:815-630-4859
Mailing Address - Fax:815-630-4860
Practice Address - Street 1:852 SHARP DR
Practice Address - Street 2:UNIT J
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-8843
Practice Address - Country:US
Practice Address - Phone:815-630-4859
Practice Address - Fax:815-630-4860
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor