Provider Demographics
NPI:1811649775
Name:WORK, NACHELLE (RT(R)(T)(CT))
Entity type:Individual
Prefix:
First Name:NACHELLE
Middle Name:
Last Name:WORK
Suffix:
Gender:F
Credentials:RT(R)(T)(CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DAVIS WOODS
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-7114
Mailing Address - Country:US
Mailing Address - Phone:618-604-7453
Mailing Address - Fax:
Practice Address - Street 1:11 DAVIS WOODS
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-7114
Practice Address - Country:US
Practice Address - Phone:618-604-7453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4514142471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography