Provider Demographics
NPI:1235119777
Name:THILL, JAMES L (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:THILL
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 1:1040 BUSSE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-971-4184
Mailing Address - Fax:224-585-8122
Practice Address - Street 1:1040 BUSSE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-971-4184
Practice Address - Fax:224-585-8122
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6784OtherMEDICARE PTAN
ILU86744Medicare UPIN