Provider Demographics
NPI:1487678595
Name:HULSEBUS, JAMES PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:HULSEBUS
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 1:1010 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:MACHESNEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61115-2518
Mailing Address - Country:US
Mailing Address - Phone:815-654-1044
Mailing Address - Fax:815-639-3529
Practice Address - Street 1:1010 HARLEM RD
Practice Address - Street 2:
Practice Address - City:MACHESNEY PARK
Practice Address - State:IL
Practice Address - Zip Code:61115-2518
Practice Address - Country:US
Practice Address - Phone:815-654-1044
Practice Address - Fax:815-639-3529
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT35296Medicare UPIN
ILK13088Medicare ID - Type Unspecified