Provider Demographics
NPI:1477515708
Name:GERLEMAN, JENNIFER JAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JAYNE
Last Name:GERLEMAN
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 1:119 RODEWALD DR
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62681-9783
Mailing Address - Country:US
Mailing Address - Phone:217-322-2370
Mailing Address - Fax:217-322-2874
Practice Address - Street 1:119 RODEWALD DR
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-9783
Practice Address - Country:US
Practice Address - Phone:217-322-2370
Practice Address - Fax:217-322-2874
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08530076OtherBLUECROSS BLUESHIELD
ILK51317Medicare PIN
IL08530076OtherBLUECROSS BLUESHIELD
703120Medicare ID - Type Unspecified