Provider Demographics
NPI:1609898568
Name:MIYOSHI, NANCY NAOMI (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:NAOMI
Last Name:MIYOSHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4914
Mailing Address - Country:US
Mailing Address - Phone:847-843-8665
Mailing Address - Fax:847-843-8118
Practice Address - Street 1:142 WHIGGINS RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-843-8665
Practice Address - Fax:847-843-8118
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01605805OtherBCBS
ILU52079Medicare UPIN
ILK25151Medicare ID - Type Unspecified