Provider Demographics
NPI:1003823261
Name:NABZDYK, JAMES J (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:NABZDYK
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 1:16310 S LINCOLN HWY STE 124
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-9060
Mailing Address - Country:US
Mailing Address - Phone:815-782-8440
Mailing Address - Fax:815-926-5305
Practice Address - Street 1:16310 S LINCOLN HWY STE 124
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-9060
Practice Address - Country:US
Practice Address - Phone:815-782-8440
Practice Address - Fax:815-926-5305
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038006811OtherLICENSE #
IL09932409OtherBC/BS PROVIDER #
ILU33101Medicare UPIN
IL213356Medicare ID - Type UnspecifiedMEDICRAE GROUP PROVIDER #