MEDICARE: NOBBE CHIROPRACTIC OFFICE LTD.

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
1	111N00000X	Chiropractor	060003381 038003552	IL

General Provider Information

NPI Number	:	1104044734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOBBE CHIROPRACTIC OFFICE LTD.

Provider Business Mailing Address
First Line	:	301 MCCROSKY PROFESSIONAL PARK
Second Line	:
City	:	COLUMBIA
State	:	IL
Zip	:	62236-2473
Country	:	US
Telephone Number	:	618-281-4000
Fax Number	:	618-281-5558

Provider Business Practice Location Address
First Line	:	301 MCCROSKY PROFESSIONAL PARK
Second Line	:
City	:	COLUMBIA
State	:	IL
Zip	:	62236-2473
Country	:	US
Telephone Number	:	618-281-4000
Fax Number	:	618-281-5558

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JAMES GEORGE NOBBE
Credential	:	D.C.
Telephone Number	:	618-281-4000

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	03/14/2008

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