Provider Demographics
NPI:1891141966
Name:CHAU, JASMINE YUKIKO (DC)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:YUKIKO
Last Name:CHAU
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 1:1995 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-9128
Mailing Address - Country:US
Mailing Address - Phone:317-745-5100
Mailing Address - Fax:317-745-1267
Practice Address - Street 1:1995 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-9128
Practice Address - Country:US
Practice Address - Phone:317-745-5100
Practice Address - Fax:317-745-1267
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003104A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300031043Medicaid
1891141966OtherNPI