Healthcare Provider Details

I. General information

NPI: 1710099171
Provider Name (Legal Business Name): JAMES H STRAUSS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W FRONT ST SUITE 400A
BLOOMINGTON IL
61701-5048
US

IV. Provider business mailing address

19 EDGEWOOD CT
BLOOMINGTON IL
61701-7835
US

V. Phone/Fax

Practice location:
  • Phone: 309-828-2860
  • Fax: 309-827-2637
Mailing address:
  • Phone: 309-530-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: