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NPI Code Detail

MEDICARE: DR. JOYCE L NELSON ED.D

MEDICARE:  DR. JOYCE L NELSON  ED.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist056003126IL

General Provider Information

NPI Number : 1942503487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOYCE L NELSON ED.D
Provider Business Mailing Address
First Line : 8521 S INDIANA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-5622
Country : US
Telephone Number : 708-802-0708
Fax Number :
Provider Business Practice Location Address
First Line : 8521 S INDIANA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-5622
Country : US
Telephone Number : 708-802-0708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2010
Last Update Date : 12/06/2010

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Directions to “ DR. JOYCE L NELSON ED.D” Practice Location

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