Provider Demographics
NPI:1336593722
Name:NEIHLS, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:NEIHLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20558 E 1400TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEUTOPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62467-3644
Mailing Address - Country:US
Mailing Address - Phone:217-821-6852
Mailing Address - Fax:580-628-2267
Practice Address - Street 1:20558 E 1400TH AVE
Practice Address - Street 2:
Practice Address - City:TEUTOPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62467-3644
Practice Address - Country:US
Practice Address - Phone:217-821-6852
Practice Address - Fax:580-628-2267
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0552353416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport