Provider Demographics
NPI:1043551500
Name:DSILVA, NISHA (DO)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:DSILVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:KALATHIVEETIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:10 MARTIN AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6538
Mailing Address - Country:US
Mailing Address - Phone:630-961-2810
Mailing Address - Fax:630-961-2658
Practice Address - Street 1:10 MARTIN AVE STE 140
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-961-2810
Practice Address - Fax:630-961-2658
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-146805207RR0500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program