Provider Demographics
NPI:1245720291
Name:STARANKO, JOHN LEONARD (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEONARD
Last Name:STARANKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-3722
Mailing Address - Country:US
Mailing Address - Phone:815-764-1120
Mailing Address - Fax:
Practice Address - Street 1:21 S JACKSON ST STE 160
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3859
Practice Address - Country:US
Practice Address - Phone:608-362-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013214111N00000X
WI5388-12111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty