Provider Demographics
NPI:1114128287
Name:DR JAMES YOUNG , PC
Entity Type:Organization
Organization Name:DR JAMES YOUNG , PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-352-6680
Mailing Address - Street 1:1040 S LA GRANGE RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2867
Mailing Address - Country:US
Mailing Address - Phone:708-352-6680
Mailing Address - Fax:708-352-6810
Practice Address - Street 1:1040 S LA GRANGE RD
Practice Address - Street 2:UNIT C
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2867
Practice Address - Country:US
Practice Address - Phone:708-352-6680
Practice Address - Fax:708-352-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty