Provider Demographics
NPI:1538215983
Name:RAY, NANCY RENEE (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:RENEE
Last Name:RAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:RENEE
Other - Last Name:RAY-WHIPPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30340 N DARRELL RD
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60051-7202
Mailing Address - Country:US
Mailing Address - Phone:815-759-2339
Mailing Address - Fax:
Practice Address - Street 1:30340 N DARRELL RD
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60051-7202
Practice Address - Country:US
Practice Address - Phone:815-759-2339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL661163OtherACN
IL01625406OtherBCBS
IL01625406OtherBCBS
IL661163OtherACN