Provider Demographics
NPI:1699032557
Name:JEANETTE K. FEFLES LTD.
Entity Type:Organization
Organization Name:JEANETTE K. FEFLES LTD.
Other - Org Name:FEFLES FAMILY CHIROPRACTIC INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FEFLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-671-1444
Mailing Address - Street 1:12505 S RIDGELAND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1867
Mailing Address - Country:US
Mailing Address - Phone:708-671-1444
Mailing Address - Fax:708-671-1433
Practice Address - Street 1:12505 S RIDGELAND AVE STE 2
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1867
Practice Address - Country:US
Practice Address - Phone:708-671-1444
Practice Address - Fax:708-671-1433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.009574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty