Provider Demographics
NPI:1588967079
Name:SEBBY, JON BRADLEY (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:BRADLEY
Last Name:SEBBY
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 1:2 NORTHFIELD PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1217
Mailing Address - Country:US
Mailing Address - Phone:847-957-8660
Mailing Address - Fax:
Practice Address - Street 1:2 NORTHFIELD PLZ STE 100
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1217
Practice Address - Country:US
Practice Address - Phone:847-957-8660
Practice Address - Fax:847-957-8661
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011836111N00000X
IL038.011836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038011836OtherILLINOIS LICENSE