Provider Demographics
NPI:1346259553
Name:KERKHOFF, JARROD STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JARROD
Middle Name:STEVEN
Last Name:KERKHOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 RIVER LN
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-5040
Mailing Address - Country:US
Mailing Address - Phone:815-633-7272
Mailing Address - Fax:815-633-7274
Practice Address - Street 1:421 RIVER LN
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-5040
Practice Address - Country:US
Practice Address - Phone:815-633-7272
Practice Address - Fax:815-633-7274
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0038-8334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0038-8334Medicaid
IL0038-8334Medicaid
ILU70126Medicare UPIN