Provider Demographics
NPI:1801440557
Name:NTOR-UE, CHRIS NAYOR (DC LAC)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:NAYOR
Last Name:NTOR-UE
Suffix:
Gender:M
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1272
Mailing Address - Country:US
Mailing Address - Phone:217-864-5566
Mailing Address - Fax:217-330-5710
Practice Address - Street 1:103 E ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:MT ZION
Practice Address - State:IL
Practice Address - Zip Code:62549-1272
Practice Address - Country:US
Practice Address - Phone:217-864-5566
Practice Address - Fax:217-864-4497
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001483171100000X
IL038013406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist