Provider Demographics
NPI:1386604643
Name:BRIGGS, JAMES A (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2344
Mailing Address - Country:US
Mailing Address - Phone:618-498-8806
Mailing Address - Fax:618-798-8812
Practice Address - Street 1:903 S STATE ST
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2344
Practice Address - Country:US
Practice Address - Phone:618-498-8806
Practice Address - Fax:618-798-8812
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038009545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
477779OtherHEALTHLINK
IL04232007OtherBCBS ILLINOIS
201643533OtherTRICARE
224252OtherGHP
IL038009545Medicaid
U89003OtherMERCY
U89003Medicare UPIN
IL038009545Medicaid