Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 209024355 | IL |
NPI | 1063179141 |
---|---|
Provider Name | Compton Nathaniel Paul |
First Address | Aurora, IL 60503-4934 |
Second Address | Aurora, IL 60503-4934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2021 |
Last Update Date | 23/11/2021 |