Provider Demographics
NPI:1225712953
Name:NISHAAN NAGARAKANTI DO
Entity Type:Organization
Organization Name:NISHAAN NAGARAKANTI DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HNATIW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-241-1495
Mailing Address - Street 1:9715 WOODS DR UNIT 506
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4440
Mailing Address - Country:US
Mailing Address - Phone:630-697-3594
Mailing Address - Fax:
Practice Address - Street 1:9715 WOODS DR UNIT 506
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4440
Practice Address - Country:US
Practice Address - Phone:630-697-3594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty