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Organization
JOHN R WASEM DC PC
Active
Organization
JOHN R WASEM DC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R WASEM DC (CORPORATION PRESIDENT)
(217) 428-2322
Entity
Organization
Contact information
Practice address
1358 N OAKLAND AVE, DECATUR, IL 62526-3737
(217) 428-2322
(217) 428-1170
Mailing address
1358 N OAKLAND AVE, DECATUR, IL 62526-3737
(217) 428-2322
(217) 428-1170
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIROPRACTOR
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005821789
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/28/2007
Last updated
08/22/2020
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