Provider Demographics
NPI:1760880603
Name:ROUMPAKIS, NICHOLAS J (DC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:J
Last Name:ROUMPAKIS
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 1:2103 NORMANDY RD.
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:46375-1816
Mailing Address - Country:US
Mailing Address - Phone:219-322-7346
Mailing Address - Fax:
Practice Address - Street 1:5962 N. LINCOLN AVE.
Practice Address - Street 2:SUITE #12
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3512
Practice Address - Country:US
Practice Address - Phone:773-989-4305
Practice Address - Fax:773-989-7450
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004048111N00000X
IN08000688A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor