Provider Demographics
NPI:1275707390
Name:NORTH SHORE NAPRAPATHICS
Entity Type:Organization
Organization Name:NORTH SHORE NAPRAPATHICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-715-8581
Mailing Address - Street 1:3930 WASHINGTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3930 WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5702
Practice Address - Country:US
Practice Address - Phone:847-244-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181-000162172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Single Specialty