Healthcare Provider Details

I. General information

NPI: 1275475931
Provider Name (Legal Business Name): NATHAN SPERR
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MAPLE AVE
ROCHELLE IL
61068-8926
US

IV. Provider business mailing address

102 MAPLE AVE
ROCHELLE IL
61068-8926
US

V. Phone/Fax

Practice location:
  • Phone: 815-562-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038.014343
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: