Provider Demographics
NPI:1841288412
Name:LAMBIN, JAMIE EILEEN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:EILEEN
Last Name:LAMBIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S CHICAGO ST
Mailing Address - Street 2:STE #2
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-1478
Mailing Address - Country:US
Mailing Address - Phone:309-944-0175
Mailing Address - Fax:309-944-0176
Practice Address - Street 1:105 S CHICAGO ST
Practice Address - Street 2:STE #2
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-1478
Practice Address - Country:US
Practice Address - Phone:309-944-0175
Practice Address - Fax:309-944-0176
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010316111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILV03791Medicare UPIN
IL210994Medicare ID - Type Unspecified