Provider Demographics
NPI:1134276231
Name:JAMES, ROBERT LEVI (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEVI
Last Name:JAMES
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 1:400 W 76TH ST
Mailing Address - Street 2:360
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-1640
Mailing Address - Country:US
Mailing Address - Phone:773-651-8124
Mailing Address - Fax:773-651-9562
Practice Address - Street 1:400 W 76TH ST
Practice Address - Street 2:360
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1640
Practice Address - Country:US
Practice Address - Phone:773-651-8124
Practice Address - Fax:773-651-9562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633384OtherPPO BLUE CROSS BLUE SHIEL
IL01633384OtherPPO BLUE CROSS BLUE SHIEL