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NPI Code Detail

MEDICARE: NATHANAEL NASH

MEDICARE: NATHANAEL NASH
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1770431454
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANAEL NASH
Provider Business Mailing Address
First Line : 2464 N CLYBOURN AVE STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1918
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2464 N CLYBOURN AVE STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1918
Country : US
Telephone Number : 773-888-1681
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2026
Last Update Date : 03/19/2026

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