Provider Demographics
NPI:1861819401
Name:CARROLL, JAMES F (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:CARROLL
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 1:123 S AURORA ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-2703
Mailing Address - Country:US
Mailing Address - Phone:331-218-5755
Mailing Address - Fax:
Practice Address - Street 1:123 S AURORA ST
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-2703
Practice Address - Country:US
Practice Address - Phone:224-419-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3295237700000X
IL038.012589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No111N00000XChiropractic ProvidersChiropractor