Provider Demographics
NPI:1720091150
Name:SOLAN, JOSEPH J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:SOLAN
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 1:3782 E 1800TH AVE
Mailing Address - Street 2:
Mailing Address - City:SHUMWAY
Mailing Address - State:IL
Mailing Address - Zip Code:62461-2020
Mailing Address - Country:US
Mailing Address - Phone:217-821-9934
Mailing Address - Fax:
Practice Address - Street 1:427 W ORCHARD ST
Practice Address - Street 2:STE B
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1256
Practice Address - Country:US
Practice Address - Phone:618-283-0029
Practice Address - Fax:618-283-4675
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038-008912OtherCHIROPRACTIC PHYSICIAN
ILU88704Medicare UPIN