Provider Demographics
NPI:1437199098
Name:NAKISHER, STEVEN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:NAKISHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:
Other - Last Name:NAKISHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:405 N WABASH AVE
Mailing Address - Street 2:SUITE NUMBER 208
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3591
Mailing Address - Country:US
Mailing Address - Phone:312-519-9000
Mailing Address - Fax:312-755-7001
Practice Address - Street 1:405 N WABASH AVE
Practice Address - Street 2:SUITE NUMBER 208
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3591
Practice Address - Country:US
Practice Address - Phone:312-519-9000
Practice Address - Fax:312-755-7001
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005565103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21623432OtherBCBS
IL21623432OtherBCBS