Healthcare Provider Details
I. General information
NPI: 1548229065
Provider Name (Legal Business Name): DONALD D NASH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/22/2006
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
610 S MAPLE AVE SUITE 2900
OAK PARK IL
60304-1091
US
IV. Provider business mailing address
1730 PARK ST SUITE 101
NAPERVILLE IL
60563-2688
US
V. Phone/Fax
- Phone: 708-383-0088
- Fax: 708-660-2975
- Phone: 630-718-0200
- Fax: 630-718-0900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 036056336 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: