Provider Demographics
NPI:1194010827
Name:FOLEY, NATHAN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:LEE
Last Name:FOLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 SADDLE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-0718
Mailing Address - Country:US
Mailing Address - Phone:815-717-8646
Mailing Address - Fax:888-277-2298
Practice Address - Street 1:1215 N CEDAR RD
Practice Address - Street 2:SUITE1
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1293
Practice Address - Country:US
Practice Address - Phone:815-717-8646
Practice Address - Fax:888-277-2298
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor