| Doctor Name: | JAMES PAUL GIBB |
| NPI Number: | 1437393824 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 180008191 |
| Business Practice Address: | 2619 W Heading Ave Suite 215 West Peoria, IL - 616044971 |
| Business Phone Number: | 3099662989 |
| Business Fax Number: | 3099664560 |
| Mailing Address: | 2619 W Heading Ave, Suite 215 WEST PEORIA |
| State: | IL |
| Postal Code: | 616044971 |
| Phone Number: | 2172480854 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2009 |
| NPI Last Update Date: | 12/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180008191 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |