Provider Demographics
NPI:1255529418
Name:WERNZ, JOHN ROBERT (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:WERNZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:IL
Mailing Address - Zip Code:62477-1018
Mailing Address - Country:US
Mailing Address - Phone:217-279-3814
Mailing Address - Fax:
Practice Address - Street 1:326 W UNION ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:IL
Practice Address - Zip Code:62477-1018
Practice Address - Country:US
Practice Address - Phone:217-279-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01223080OtherBCBS
IL01223080OtherBCBS