Provider Demographics
NPI:1407914781
Name:CLOUSING, JAMES LOUIS (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LOUIS
Last Name:CLOUSING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N 121 COUNTY FARM ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190
Mailing Address - Country:US
Mailing Address - Phone:630-668-4070
Mailing Address - Fax:630-681-0305
Practice Address - Street 1:1 N 121 COUNTY FARM ROAD
Practice Address - Street 2:SUITE 140
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-668-4070
Practice Address - Fax:630-681-0305
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190171771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice