Individual
DR. KRISTOPHER WADE WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
448 COLE ST, BUSHNELL, IL 61422-1540
(309) 772-2317
(309) 772-2317
Mailing address
448 COLE ST, BUSHNELL, IL 61422-1540
(309) 772-2317
(309) 772-2317
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
111NR0200X
Radiology Chiropractor
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5522061
BC/BS NUMBER
IL
Enumeration date
07/11/2006
Last updated
10/01/2007
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