Provider Demographics
NPI:1942372727
Name:FEFLES, JEANETTE K (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:K
Last Name:FEFLES
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 1:12505 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
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0007872498OtherAETNA
IL4268363OtherCIGNA
IL4268363OtherCIGNA
IL0007872498OtherAETNA