Jonathan David Diaz, D.C.
Individual provider Active NPI Chiropractor · West Frankfort, IL
NPI 1861660102 · NPPES record last updated Feb 20, 2008
Key facts
- NPI
- 1861660102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- Practice address
- 607 W Oak St
West Frankfort, IL 62896-2561 - Phone
- (618) 435-2500
- NPI assigned
- Feb 20, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 038011132 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McGuire Chiropractic Clinic S.C. | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Yes |
Addresses
Primary practice location
607 W Oak St
West Frankfort, IL 62896-2561
Mailing address
805 N Main St
Benton, IL 62812-1019
Phone (618) 435-2500
Other providers in West Frankfort, IL
- Deaconess Illinois Specialty Clinic, Inc.
- Deaconess Illinois Specialty Clinic, Inc.
- Tamara Delong
- Amanda Denney
- Kelsie Deppen
- Robert Thomas Dinga
- Clark A Dixon
- Kortez Dixon
- Rachal Rebecca Doolin
- Jason Dorris
All providers in West Frankfort, IL · Chiropractor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2008. 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.