Individual
DR. JAMES MICHAEL BOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4965 E LOST BRIDGE RD, DECATUR, IL 62521-5139
(217) 864-5531
Mailing address
113 E SEIBERLING ST, BLUE MOUND, IL 62513-0260
(217) 692-2151
(217) 692-2121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-077533
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-077533
STATE LICENSE
IL
05
—
036-077533
—
IL
Enumeration date
08/05/2006
Last updated
03/07/2023
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