James, Theodore G

James, Theodore G is an sole proprietor health care provider with primary practice located at 2310 York St Ste 2C, Blue Island IL 60406-2411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. James, Theodore G can be contacted via phone (708) 388-4903.

Contact Information

Primary practice address
2310 York St Ste 2C Blue Island IL 60406-2411
Phone: (708) 388-4903
Fax: (708) 388-0043
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036039906 Illinois

Profile Details

NPI number 1598741050
LBN Legal business name James, Theodore G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2005
Last updated Apr 21st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598741050 NPPES
Other 080178217 RR MEDICARE
Other 1626986 RR MEDICARE
MEDICAID 036039906 RR MEDICARE

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