Provider Demographics
NPI:1265699953
Name:HEWING, JENNIFER LYNN (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HEWING
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 1:1014 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1442
Mailing Address - Country:US
Mailing Address - Phone:217-324-7755
Mailing Address - Fax:217-324-7707
Practice Address - Street 1:101 N OLD ROUTE 66
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-2639
Practice Address - Country:US
Practice Address - Phone:217-324-7755
Practice Address - Fax:217-324-7707
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor