Individual
JACOB DALE WOOKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
630 TERRA WEST DR, FREEPORT, IL 61032-4536
(815) 235-7858
(815) 235-7913
Mailing address
1615 SUMMIT DR, STOCKTON, IL 61085-9126
(815) 947-3320
(815) 947-3380
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
06885
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038011028
—
IL
01
—
08982007
BCBS GROUP
IL
01
—
210296
MEDICARE GROUP
IL
Enumeration date
05/09/2006
Last updated
10/23/2009
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