Provider Demographics
NPI:1932244654
Name:NAGY, D. KEITH (OD)
Entity Type:Individual
Prefix:DR
First Name:D.
Middle Name:KEITH
Last Name:NAGY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 SHERAL CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1345
Mailing Address - Country:US
Mailing Address - Phone:217-446-3554
Mailing Address - Fax:
Practice Address - Street 1:2917 N VERMILION ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1366
Practice Address - Country:US
Practice Address - Phone:217-431-7118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37929Medicare ID - Type Unspecified