MEDICARE: DR. ROBERT LEVI JAMES DC

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01633384	OTHER	IL	PPO BLUE CROSS BLUE SHIEL

General Provider Information

NPI Number	:	1134276231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LEVI JAMES DC

Provider Business Mailing Address
First Line	:	400 W 76TH ST
Second Line	:	360
City	:	CHICAGO
State	:	IL
Zip	:	60620-1640
Country	:	US
Telephone Number	:	773-651-8124
Fax Number	:	773-651-9562

Provider Business Practice Location Address
First Line	:	400 W 76TH ST
Second Line	:	360
City	:	CHICAGO
State	:	IL
Zip	:	60620-1640
Country	:	US
Telephone Number	:	773-651-8124
Fax Number	:	773-651-9562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/08/2007

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