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Individual

JAKE P CHANGELON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
10705 RUTH RD, HUNTLEY, IL 60142-7156
(815) 342-7167
Mailing address
10705 RUTH RD, HUNTLEY, IL 60142-7156
(815) 342-7167

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38013625
IL

Other

Enumeration date
11/21/2020
Last updated
11/21/2020
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