Provider Demographics
NPI:1578891578
Name:NISENGOLTS, MEER (MD)
Entity Type:Individual
Prefix:MR
First Name:MEER
Middle Name:
Last Name:NISENGOLTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 W. GREENLEAF
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714
Mailing Address - Country:US
Mailing Address - Phone:847-966-8706
Mailing Address - Fax:
Practice Address - Street 1:7117 W. GREENLEAF
Practice Address - Street 2:PEDIATRICS, M.D.
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714
Practice Address - Country:US
Practice Address - Phone:847-966-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.069317208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics