Provider Demographics
NPI:1871656124
Name:HALLUM, JENNIFER ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:HALLUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:SCHAUFLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:43 W ACORN LN
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-4804
Mailing Address - Country:US
Mailing Address - Phone:847-658-8541
Mailing Address - Fax:847-658-7395
Practice Address - Street 1:43 W ACORN LN
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-4804
Practice Address - Country:US
Practice Address - Phone:847-658-8541
Practice Address - Fax:847-658-7395
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212937Medicare ID - Type Unspecified