Provider Demographics
NPI:1770538902
Name:JOHNIGK, JOSEPH FRANCES I (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANCES
Last Name:JOHNIGK
Suffix:I
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 1:4903 S BECKER DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:BARTONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61607-2848
Mailing Address - Country:US
Mailing Address - Phone:309-697-9617
Mailing Address - Fax:309-697-9116
Practice Address - Street 1:4903 S BECKER DR
Practice Address - Street 2:SUITE D
Practice Address - City:BARTONVILLE
Practice Address - State:IL
Practice Address - Zip Code:61607-2848
Practice Address - Country:US
Practice Address - Phone:309-697-9617
Practice Address - Fax:309-697-9116
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL267980Medicare ID - Type UnspecifiedPROVIDER#