Provider Demographics
NPI:1013095983
Name:SIMA, JEFFREY S (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:SIMA
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 1:1117 S MILWAUKEE AVE STE D7
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5257
Mailing Address - Country:US
Mailing Address - Phone:847-247-1830
Mailing Address - Fax:847-367-4904
Practice Address - Street 1:1117 S MILWAUKEE AVE STE D7
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5257
Practice Address - Country:US
Practice Address - Phone:847-247-1830
Practice Address - Fax:847-367-4904
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4926560OtherBLUE CROSS BLUE SHIELD
IL4926560OtherBLUE CROSS BLUE SHIELD