Provider Demographics
NPI:1528192531
Name:WILKE, SHAWN ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:ELIZABETH
Last Name:WILKE
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 1:1230 STOWE ST
Mailing Address - Street 2:PO BOX 362
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4868
Mailing Address - Country:US
Mailing Address - Phone:319-572-0157
Mailing Address - Fax:
Practice Address - Street 1:1230 STOWE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4868
Practice Address - Country:US
Practice Address - Phone:319-572-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor