Provider Demographics
NPI:1588805394
Name:RAY, NANCY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:S
Last Name:RAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 N. DEARBORN
Mailing Address - Street 2:#2706
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610
Mailing Address - Country:US
Mailing Address - Phone:312-726-5007
Mailing Address - Fax:
Practice Address - Street 1:55 E WASHINGTON
Practice Address - Street 2:#2600
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602
Practice Address - Country:US
Practice Address - Phone:312-726-5007
Practice Address - Fax:312-346-4662
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190218921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice