Individual
DR. DAVID E JANECEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
505 N JACKSON ST, FAIRBURY, IL 61739-1040
(815) 692-4204
Mailing address
505 N JACKSON ST, FAIRBURY, IL 61739-1040
(815) 692-4420
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038003756
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003756
—
IL
01
—
08182039
BCBS
—
01
—
777130
MEDICARE PTAN
IL
Enumeration date
11/01/2006
Last updated
08/15/2023
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