Active NPI
Jamil Mousa Tannous, D.C.,
- Chiropractor
- Waterloo, IL
National Provider Identifier
1821241142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.007988
- Practice address
- 121 N Main St
Waterloo, IL 62298-1202 - Phone
- (618) 939-7167
- NPI assigned
- Oct 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.007988 | IL | Primary |
Addresses
Primary practice location
121 N Main St
Waterloo, IL 62298-1202
Mailing address
121 N Main St
Waterloo, IL 62298-1202
Phone (618) 939-7167
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.007988 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1821241142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 N MAIN ST",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981202",
"telephone_number": "618-939-7167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 N MAIN ST",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981202",
"telephone_number": "618-939-7167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNOUS",
"first_name": "JAMIL",
"middle_name": "MOUSA",
"credential": "D.C.,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-30",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.007988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.