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Individual

DR. JERIJO MARIE HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
2728 HILLSIDE DR, DELAFIELD, WI 53018-2164
(262) 303-4252
Mailing address
2625 BUTTERFIELD RD, SUITE 301N, OAK BROOK, IL 60523-1234
(630) 320-6400
(630) 701-1007

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010283
IL
111N00000X
Chiropractor
Primary
5433-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1635113
BLUE CROSS ID #
IL
01
211550
OLD MEDICARE PIN
IL
01
214291
NEW MEDICARE PIN
IL
01
K17158
OLD MEDICARE #
IL
01
K32013
NEW MEDICARE #
IL
Enumeration date
06/05/2006
Last updated
09/03/2019
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