Individual
DR. JACKIE LYNN DANIELS-LAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2060 W WASHINGTON ST, SPRINGFIELD, IL 62702-6630
(217) 793-8266
(217) 793-8265
Mailing address
2060 W WASHINGTON ST, SPRINGFIELD, IL 62702-6630
(217) 793-8266
(217) 793-8265
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008425812
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/14/2007
Last updated
07/08/2007
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