Provider Demographics
NPI:1861827859
Name:JUUL, BONNIE JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:JEAN
Last Name:JUUL
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 1:701 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2643
Mailing Address - Country:US
Mailing Address - Phone:618-351-9364
Mailing Address - Fax:
Practice Address - Street 1:701 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2643
Practice Address - Country:US
Practice Address - Phone:618-351-9364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor