Provider Demographics
NPI:1508945726
Name:LOVELL, JAMES R (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:LOVELL
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 1:8951 W CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-1157
Mailing Address - Country:US
Mailing Address - Phone:708-477-4800
Mailing Address - Fax:708-447-0919
Practice Address - Street 1:8951 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:NORTH RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1157
Practice Address - Country:US
Practice Address - Phone:708-477-4800
Practice Address - Fax:708-447-0919
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL592490Medicare ID - Type UnspecifiedMEDICARE PROVIDER #