Provider Demographics
NPI:1649241191
Name:NOBBE, JAMES GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GEORGE
Last Name:NOBBE
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 1:301 MCCROSKY PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:IL
Mailing Address - Zip Code:62236-2473
Mailing Address - Country:US
Mailing Address - Phone:618-281-4000
Mailing Address - Fax:618-281-5558
Practice Address - Street 1:301 MCCROSKY PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2473
Practice Address - Country:US
Practice Address - Phone:618-281-4000
Practice Address - Fax:618-281-5558
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038003552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK49799Medicare PIN