Provider Demographics
NPI:1437308467
Name:GREGORY S NILIUS PC
Entity Type:Organization
Organization Name:GREGORY S NILIUS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NILIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-397-3339
Mailing Address - Street 1:2506 N 72ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-7012
Mailing Address - Country:US
Mailing Address - Phone:402-397-3339
Mailing Address - Fax:
Practice Address - Street 1:2506 N 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-7012
Practice Address - Country:US
Practice Address - Phone:402-397-3339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE50788752500Medicaid
NE350042369OtherRAIL ROAD MEDICAID
NE50788752500Medicaid
NEU69760Medicare UPIN
NE350042369OtherRAIL ROAD MEDICAID