Church, Dane Jack

Church, Dane Jack is an sole proprietor health care provider with primary practice located at 1301 S Koke Mill Rd , Springfield IL 62711-9252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, which is considered as his primary health care specialty. Church, Dane Jack can be contacted via phone (217) 547-9100.

Contact Information

Primary practice address
1301 S Koke Mill Rd Springfield IL 62711-9252
Phone: (217) 547-9100
Fax: (217) 547-9236
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X 036148467 Illinois

Profile Details

NPI number 1790128387
LBN Legal business name Church, Dane Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 12th, 2013
Last updated Apr 13th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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