Provider Demographics
NPI:1972078822
Name:NAGEL, MYLES (DC)
Entity type:Individual
Prefix:
First Name:MYLES
Middle Name:
Last Name:NAGEL
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 1:666 DUNDEE RD STE 1706
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2738
Mailing Address - Country:US
Mailing Address - Phone:847-498-1222
Mailing Address - Fax:
Practice Address - Street 1:666 DUNDEE RD STE 1706
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2738
Practice Address - Country:US
Practice Address - Phone:847-498-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor