Provider Demographics
NPI:1972664951
Name:HOLMAN, NANCY N (DC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:N
Last Name:HOLMAN
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 1:82 WEST 63RD ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:630-455-4210
Mailing Address - Fax:630-455-4211
Practice Address - Street 1:42W580 EMPIRE RD
Practice Address - Street 2:FRNT 1
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-8384
Practice Address - Country:US
Practice Address - Phone:630-484-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038006089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02215551OtherBLUE CROSS
IL038006089OtherSTATE LICENSE
ILP00229775OtherRAIL ROAD MEDICARE
IL792780Medicare ID - Type Unspecified