Demetrius Cornell Nance

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

415 Washington St
Waukegan, IL 60085-5564

Phone

(847) 441-5600

NPI assigned

Sep 28, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1083338669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CENTRAL AVE",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855564",
            "telephone_number": "847-441-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "DEMETRIUS",
        "middle_name": "CORNELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-28",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Ellen Murphy
• Maureen McGarrity Murphy, LCSW
• Ujjvala Nadkarni, MD
• Saima D Najam, MD
• Maureen Nakayenze, BSW
• Nancy S. Wallace, D.M.D., LTD.
• Patricia Ann Napier, RN
• Mary Ellen Nash, MSW,LSW
• Erica Nathan
• Katherine Lorelen Nauert-Dineen

• Clinical Social Worker in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.