Provider Demographics
NPI:1013248525
Name:TEWS, NATHANIEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:J
Last Name:TEWS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 W GRAND AVE
Mailing Address - Street 2:UNIT 109
Mailing Address - City:FOX LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60020-1262
Mailing Address - Country:US
Mailing Address - Phone:847-587-0003
Mailing Address - Fax:847-587-0210
Practice Address - Street 1:2 W GRAND AVE
Practice Address - Street 2:UNIT 109
Practice Address - City:FOX LAKE
Practice Address - State:IL
Practice Address - Zip Code:60020-1262
Practice Address - Country:US
Practice Address - Phone:847-587-0003
Practice Address - Fax:847-587-0210
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor