Healthcare Provider Details

I. General information

NPI: 1780233791
Provider Name (Legal Business Name): JAMES CHRISTOPHER BACH DN, DNH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 W GRAND AVE APT 1
CHICAGO IL
60642-6478
US

IV. Provider business mailing address

1368 W GRAND AVE APT 1
CHICAGO IL
60642-6478
US

V. Phone/Fax

Practice location:
  • Phone: 312-505-7474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number70156
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: