Provider Demographics
NPI:1437688579
Name:NANI, PETER J (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:NANI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1425 N HUNT CLUB RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-2632
Mailing Address - Country:US
Mailing Address - Phone:847-548-2200
Mailing Address - Fax:847-548-2865
Practice Address - Street 1:1425 N HUNT CLUB RD STE 100
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2632
Practice Address - Country:US
Practice Address - Phone:847-548-2200
Practice Address - Fax:847-548-2865
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2024-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036154622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine