Individual
NATHANIEL OVERTON HOLLOWAY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7531 S STONY ISLAND AVE, BASEMENT, CHICAGO, IL 60649-3954
(773) 947-7850
(773) 947-7852
Mailing address
3400 N LAKE SHORE DR, UNIT 9-B, CHICAGO, IL 60657-2827
(773) 947-7850
(773) 947-7852
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
036073542
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073542
—
IL
Enumeration date
05/23/2006
Last updated
07/20/2009
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