Provider Demographics
NPI:1598885048
Name:PERULFI, JAMES F (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:PERULFI
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 1:3359 GARVEY LN
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3232
Mailing Address - Country:US
Mailing Address - Phone:618-628-4488
Mailing Address - Fax:
Practice Address - Street 1:310 E HIGHWAY 50
Practice Address - Street 2:SUITE 2
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-2700
Practice Address - Country:US
Practice Address - Phone:618-628-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL705151OtherHEALTHLINK
IL08232177OtherBLUE CROSS BLUE SHIELD
IL705151OtherHEALTHLINK
ILU72163Medicare UPIN
ILK24492Medicare ID - Type Unspecified