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NPI Code Detail

MEDICARE: CHARLES JAMES M.D.

MEDICARE: CHARLES JAMES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171000000XMilitary Health Care Provider036-063788IL
22085R0202XDiagnostic Radiology Physician336-028241IL

General Provider Information

NPI Number : 1114025483
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES JAMES M.D.
Provider Business Mailing Address
First Line : 820 S. DAMEN AVE.
Second Line : JESSE BROWN VAMC; DEPARTMENT OF RADIOLOGY
City : CHICAGO
State : IL
Zip : 60612-3728
Country : US
Telephone Number : 312-569-7735
Fax Number : 312-569-8102
Provider Business Practice Location Address
First Line : JESSE BROWN VAMC; 820 S. DAMEN AVE.
Second Line : DEPARTMENT OF RADIOLOGY; ROOM NUMBER 4436
City : CHICAGO
State : IL
Zip : 60612-3728
Country : US
Telephone Number : 312-569-7735
Fax Number : 312-569-8102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 03/16/2009

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