Provider Demographics
NPI:1265558837
Name:PROBST, JOSEPH C (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:PROBST
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 1:1407 PATE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BELOIT
Mailing Address - State:IL
Mailing Address - Zip Code:61080-1431
Mailing Address - Country:US
Mailing Address - Phone:815-389-7870
Mailing Address - Fax:815-389-7870
Practice Address - Street 1:1407 PATE PLAZA DR
Practice Address - Street 2:
Practice Address - City:SOUTH BELOIT
Practice Address - State:IL
Practice Address - Zip Code:61080-1431
Practice Address - Country:US
Practice Address - Phone:815-389-7870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008186111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician