Individual
NATHAN ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1850 OAK ST, NORTHFIELD, IL 60093-3042
(224) 505-5593
Mailing address
1850 OAK ST, NORTHFIELD, IL 60093-3042
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
03/08/2022
Last updated
03/08/2022
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