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:
Health care specialties
| Specialty | Code | License # | 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 5 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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