Individual
DR. JEFFREY K STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
214 S LINDEN ST, NORMAL, IL 61761-3008
(309) 454-8622
(309) 454-8626
Mailing address
214 S LINDEN ST, NORMAL, IL 61761-3008
(309) 454-8622
(309) 454-8626
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006591
HEALTH ALLIANCE
IL
01
—
5715400
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/30/2006
Last updated
10/25/2011
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