Branch, Nathaniel
Branch, Nathaniel is an sole proprietor health care provider with primary practice located at 12 Health Services Dr , Dekalb IL 60115-9637. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Branch, Nathaniel can be contacted via phone (815) 756-4875.Contact Information
Primary practice address
12 Health Services Dr
Dekalb IL 60115-9637
Phone: (815) 756-4875
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1043920036 |
|---|---|
| LBN Legal business name | Branch, Nathaniel |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2022 |
| Last updated | Nov 30th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043920036 | NPPES |
| Illinois | MEDICAID | 4745791890010 |
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