Provider Demographics
NPI:1467057604
Name:WESTEFER, COURTNEY RAE (DC)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:RAE
Last Name:WESTEFER
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 1:116 E WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:IL
Mailing Address - Zip Code:61491-1455
Mailing Address - Country:US
Mailing Address - Phone:309-695-4471
Mailing Address - Fax:
Practice Address - Street 1:116 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:IL
Practice Address - Zip Code:61491-1455
Practice Address - Country:US
Practice Address - Phone:309-695-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor