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Individual
DR. JERIJO MARIE HALL
Active
Individual
DR. JERIJO MARIE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010283
IL
111N00000X
Chiropractor
Primary
5433-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1635113
BLUE CROSS ID #
IL
01
—
211550
OLD MEDICARE PIN
IL
01
—
214291
NEW MEDICARE PIN
IL
01
—
K17158
OLD MEDICARE #
IL
01
—
K32013
NEW MEDICARE #
IL
Enumeration date
06/05/2006
Last updated
09/03/2019
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