Provider Demographics
NPI:1255740635
Name:JBH MEDICAL CORPORATION LTD
Entity type:Organization
Organization Name:JBH MEDICAL CORPORATION LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHUYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-253-5505
Mailing Address - Street 1:440 W BOUGHTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1400
Mailing Address - Country:US
Mailing Address - Phone:630-759-8989
Mailing Address - Fax:
Practice Address - Street 1:440 W BOUGHTON RD STE 102
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1400
Practice Address - Country:US
Practice Address - Phone:630-759-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011006111N00000X
IL038009393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty