Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Demetrius Cornell Nance

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083338669

Demetrius Cornell Nance is a Student in an Organized Health Care Education/Training Program in Waukegan, Illinois. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
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Practice location Address checks out

415 Washington St
Waukegan, IL 60085-5564
Phone: (847) 441-5600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083338669
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 28, 2022
Last updated in NPPESJune 22, 2023
Certification dateJune 22, 2023
Mailing address405 Central Ave, Northfield, IL 60093-3006

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