Provider Demographics
NPI:1265052781
Name:NOMAD ENTERPRISES
Entity type:Organization
Organization Name:NOMAD ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PUC
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:630-251-3800
Mailing Address - Street 1:5100 FOREST AVE UNIT 208
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4855
Mailing Address - Country:US
Mailing Address - Phone:630-251-3800
Mailing Address - Fax:
Practice Address - Street 1:5100 FOREST AVE UNIT 208
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4855
Practice Address - Country:US
Practice Address - Phone:630-251-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty