Provider Demographics
NPI:1366424723
Name:FOLKERTS, JOHN P (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:FOLKERTS
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:PO BOX 380
Mailing Address - Street 2:420 S CROSSING DR
Mailing Address - City:SHERMAN
Mailing Address - State:IL
Mailing Address - Zip Code:62684
Mailing Address - Country:US
Mailing Address - Phone:217-496-3636
Mailing Address - Fax:217-496-3838
Practice Address - Street 1:420 S CROSSING DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:IL
Practice Address - Zip Code:62684
Practice Address - Country:US
Practice Address - Phone:217-496-3636
Practice Address - Fax:217-496-3838
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08408756OtherBCBS
IL350047581OtherMEDICARE RAILROAD
IL038008204Medicaid
ILK50461Medicare PIN
IL350047581OtherMEDICARE RAILROAD