Provider Demographics
NPI:1447318076
Name:ST.GERMAIN, GERMAINE LOUISE (DC)
Entity type:Individual
Prefix:
First Name:GERMAINE
Middle Name:LOUISE
Last Name:ST.GERMAIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2554
Mailing Address - Country:US
Mailing Address - Phone:630-620-7900
Mailing Address - Fax:630-620-7931
Practice Address - Street 1:13 S PARK AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2554
Practice Address - Country:US
Practice Address - Phone:630-620-7900
Practice Address - Fax:630-620-7931
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038004353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor