Provider Demographics
NPI:1568460632
Name:THOMPSON, NATHAN CHRISTIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:CHRISTIAN
Last Name:THOMPSON
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 1:664 W VETERANS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-4567
Mailing Address - Country:US
Mailing Address - Phone:630-553-6149
Mailing Address - Fax:630-553-9458
Practice Address - Street 1:664 W VETERANS PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-4567
Practice Address - Country:US
Practice Address - Phone:630-553-6149
Practice Address - Fax:630-553-9458
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208046Medicare UPIN