Provider Demographics
NPI:1851346498
Name:MC GINN, JAMES E JR (DC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:MC GINN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:318 MEMORIAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6267
Mailing Address - Country:US
Mailing Address - Phone:815-455-1910
Mailing Address - Fax:815-455-2541
Practice Address - Street 1:318 MEMORIAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6267
Practice Address - Country:US
Practice Address - Phone:815-455-1910
Practice Address - Fax:815-455-2541
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
131951OtherAMERICAN CHIRO NETWORK
131951OtherPHCS
131951OtherILLINOIS CHIRO NETWORK
IL04923223OtherBLUE CROSS B S OF IL
10619795OtherCAQH
10619795OtherUNICARE
131951OtherHOMONO
5415928OtherCIGNA
131951OtherPHCS
K04449Medicare ID - Type Unspecified
131951OtherAMERICAN CHIRO NETWORK