Organization
BOURBONNAIS CHIROPRACTIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R TRIPP DC (OWNER)
(815) 939-2225
Entity
Organization
Contact information
Practice address
201 PARK PL STE 10, BOURBONNAIS, IL 60914-1883
(815) 939-2225
(815) 939-8993
Mailing address
201 PARK PL STE 10, BOURBONNAIS, IL 60914-1883
(815) 939-2225
(815) 939-8993
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038006693
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350026295
RAILROAD MEDICARE
—
01
—
4682111
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/17/2006
Last updated
04/20/2011
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