Individual
JASON CLEO FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
525 S SCHMALE RD, CAROL STREAM, IL 60188-2451
(331) 871-2039
(630) 324-4965
Mailing address
2057 WILSON CREEK CIR, AURORA, IL 60503-3610
(314) 578-9022
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-010938
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000570383
ANTHEM BCBS
MO
01
—
P00655474
RR MEDICARE
MO
Enumeration date
07/26/2007
Last updated
06/25/2025
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