Johan C Dinkelmann, DC
Individual provider Active NPI Chiropractor · Wood River, IL
NPI 1336200286 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336200286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 21 E Acton Ave
Wood River, IL 62095 - Phone
- (618) 254-2260
- Fax
- (618) 254-2231
- NPI assigned
- Dec 13, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
21 E Acton Ave
Wood River, IL 62095
Mailing address
21 E Acton Ave
Dinkelmann Health Center SC
Wood River, IL 62095
Phone (618) 254-2260
Other providers in Wood River, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 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.