Provider Demographics
NPI:1760808307
Name:PEARSON, NAKIESHA (DC, ND)
Entity Type:Individual
Prefix:
First Name:NAKIESHA
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 OAKWOOD DR UNIT 2J
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2922
Mailing Address - Country:US
Mailing Address - Phone:260-602-8085
Mailing Address - Fax:
Practice Address - Street 1:445 AURORA AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6274
Practice Address - Country:US
Practice Address - Phone:630-355-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012009111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor