Provider Demographics
NPI:1023116456
Name:CONROY, NATHAN (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:CONROY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 S RANDALL RD
Mailing Address - Street 2:STE. C
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2532
Mailing Address - Country:US
Mailing Address - Phone:630-845-8925
Mailing Address - Fax:
Practice Address - Street 1:1881 S RANDALL RD
Practice Address - Street 2:STE. C
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2532
Practice Address - Country:US
Practice Address - Phone:630-845-8925
Practice Address - Fax:630-845-8965
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor