Individual
JANET BODNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
204 S MAIN AVE, MINIER, IL 61759-0251
(309) 392-2096
(309) 392-2496
Mailing address
PO BOX 251, MINIER, IL 61759-0251
(309) 392-2096
(309) 392-2496
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007609
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038007609
IRS EMPLOYER TAX ID #
—
05
—
358491
—
IL
Enumeration date
12/06/2006
Last updated
07/13/2010
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