Provider Demographics
NPI:1295814689
Name:YOUNG, JAMES A (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1040 S LA GRANGE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2867
Mailing Address - Country:US
Mailing Address - Phone:708-352-6680
Mailing Address - Fax:708-352-6810
Practice Address - Street 1:1040 S LA GRANGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2867
Practice Address - Country:US
Practice Address - Phone:708-352-6680
Practice Address - Fax:708-352-6810
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038009589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor