MEDICARE: JOHN M. NAYDEN SR. M.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
1	2085R0202X	Diagnostic Radiology Physician		IL

General Provider Information

NPI Number	:	1437347978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M. NAYDEN SR. M.D.

Provider Business Mailing Address
First Line	:	366 RED BUD CT
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-2128
Country	:	US
Telephone Number	:	815-469-6361
Fax Number	:	815-469-6326

Provider Business Practice Location Address
First Line	:	366 RED BUD CT
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-2128
Country	:	US
Telephone Number	:	815-469-6361
Fax Number	:	815-469-6326

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	10/10/2007

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