Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038010231 | IL |
N | 207R00000X | Internist | 038010231 | IL |
N | 111NI0900X | Internist | 038010231 | IL |
N | 111NN1001X | Nutrition | 038010231 | IL |
N | 111NP0017X | Pediatric Chiropractor | 038010231 | IL |
NPI | 1194709261 |
---|---|
Provider Name | Dr. Jodi E Perrin |
First Address | N. Aurora, IL 60542 |
Second Address | N. Aurora, IL 60542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 15/05/2019 |