Provider Demographics
NPI:1720027907
Name:SHEBUSKI, JAMES S (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:SHEBUSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 SCHOFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-2365
Mailing Address - Country:US
Mailing Address - Phone:715-355-4224
Mailing Address - Fax:715-355-4120
Practice Address - Street 1:2114 SCHOFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-2365
Practice Address - Country:US
Practice Address - Phone:715-355-4224
Practice Address - Fax:715-355-4120
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35941OtherSECURITY HEALTH PLAN
WI000435789OtherBCBS SMART VALUE
WI000435789OtherUNICARE
WI000435789OtherRRW MEDICARE
WI000435789OtherADVOCARE BY SHP
WI000435789OtherHUMANA GOLD CHOICE
WI38883800Medicaid
WI610537900OtherUS DEPARTMENT OF LABOR