Provider Demographics
NPI:1104044734
Name:NOBBE CHIROPRACTIC OFFICE LTD.
Entity Type:Organization
Organization Name:NOBBE CHIROPRACTIC OFFICE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:NOBBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-281-4000
Mailing Address - Street 1:301 MCCROSKY PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:IL
Mailing Address - Zip Code:62236-2473
Mailing Address - Country:US
Mailing Address - Phone:618-281-4000
Mailing Address - Fax:618-281-5558
Practice Address - Street 1:301 MCCROSKY PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2473
Practice Address - Country:US
Practice Address - Phone:618-281-4000
Practice Address - Fax:618-281-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060003381 038003552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty