Jason Eugene Lafferty, D.C.
Individual provider Active NPI Chiropractor · Ladd, IL
NPI 1285794909 · NPPES record last updated Nov 28, 2007
Key facts
- NPI
- 1285794909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 206 N. Main Ave.
Ladd, IL 61329-0833 - Phone
- (815) 894-9400
- Fax
- (815) 894-9403
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-009925 | IL | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
206 N. Main Ave.
Ladd, IL 61329-0833
Mailing address
206 N. Main Ave.
Ladd, IL 61329-0833
Phone (815) 894-9400
Other providers in Ladd, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.