Provider Demographics
NPI:1376550822
Name:NIELSEN, ARTHUR CHARLES III (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:CHARLES
Last Name:NIELSEN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:333 E ONTARIO ST
Mailing Address - Street 2:SUITE 4209B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4804
Mailing Address - Country:US
Mailing Address - Phone:312-649-0570
Mailing Address - Fax:847-441-7196
Practice Address - Street 1:333 E ONTARIO ST
Practice Address - Street 2:SUITE 4209B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4804
Practice Address - Country:US
Practice Address - Phone:312-649-0570
Practice Address - Fax:847-441-7196
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021609228OtherBLUE CROSS BLUE SHIELD