Jeanette  K  Fefles    DC
Contract Details
Facility name
Provider ID
P000005670
NPI
1942372727
Tax ID
770598608
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
11555 South Harlem Ave Suite C
Worth, IL 60482
United States
County
Cook
Phone
7086711444 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address