Provider Demographics
NPI:1790267805
Name:SKRABUTENAS, JENNIFER (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SKRABUTENAS
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 1:603 E DIEHL RD STE 135
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-7890
Mailing Address - Country:US
Mailing Address - Phone:630-505-4040
Mailing Address - Fax:630-505-9847
Practice Address - Street 1:603 E DIEHL RD STE 135
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-7890
Practice Address - Country:US
Practice Address - Phone:630-505-4040
Practice Address - Fax:630-505-9847
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor