Provider Demographics
NPI:1992295711
Name:GEROWITZ, NATHAN
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:GEROWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4880 EUCLID AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-7276
Mailing Address - Country:US
Mailing Address - Phone:847-991-7401
Mailing Address - Fax:
Practice Address - Street 1:4880 EUCLID AVE STE 101
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-7276
Practice Address - Country:US
Practice Address - Phone:847-991-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013173111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor