Bourbonnais Chiropractic LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038006693 Issued in IL

Legal business name

BOURBONNAIS CHIROPRACTIC LTD

Practice address

201 Park PL Ste 10
Bourbonnais, IL 60914-1883

Phone

(815) 939-2225

Fax

(815) 939-8993

NPI assigned

Nov 17, 2006

Last updated

Apr 20, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. James R Tripp, DCNPI 1770669517

Title

Owner

Phone

(815) 939-2225

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James R Tripp, DC

  • Chiropractor
  • Bourbonnais, IL
  • NPI 1770669517
  Authorized official Same address or phone
• Brian D Hillary, DC

  • Chiropractor
  • Bourbonnais, IL
  • NPI 1679647325
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1548334287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK PL STE 10",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141883",
            "telephone_number": "815-939-2225",
            "fax_number": "815-939-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK PL STE 10",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141883",
            "telephone_number": "815-939-2225",
            "fax_number": "815-939-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOURBONNAIS CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-939-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4682111",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350026295",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Jude Boudreau, M.A., LCPC
• Jessica Boudreau
• Kyle Boudreau, P.T.
• Teri Boudreau, LCPC
• Sihem Boulahbal
• Bourbonnais Elementary District 53
• Bourbonnais Fire District
• Bourbonnais Sleep Solutions LLC
• Bourbonnais Sleep Solutions LLC (Bourbonnais Sleep Solutions)
• Bourbonnais Terrace Operator LLC

• Chiropractor in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.