Individual
JERALD O DISHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
600 W MAIN ST, OLNEY, IL 62450-1542
(618) 392-2223
(618) 392-3261
Mailing address
600 W MAIN ST, OLNEY, IL 62450-1542
(618) 392-2223
(618) 392-3261
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11393326
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08020396
BCBS
IL
Enumeration date
07/15/2006
Last updated
07/08/2007
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