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General NPI Number Information
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NPI Number | 1871051706
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Entity Type | Individual
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Provider Name | NATHANIEL PROCE DC
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Gender | Male
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 199 S ADDISON RD # 105-106
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City | WOOD DALE
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State | IL
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Zip | 60191-1929
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Country | US
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Telephone | 630-766-1552
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Fax | 630-766-4220
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Provider Business Mailing Address
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Address Line | 199 S ADDISON RD # 105-106
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City | WOOD DALE
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State | IL
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Zip | 60191-1929
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Country | US
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Telephone | 630-766-1552
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Fax | 630-766-4220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12721
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 013235
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 038014201
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00763400
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License Number State | NJ
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