Provider Demographics
NPI:1609079219
Name:NAIR, ANJANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJANA
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MADISON ST STE 300
Mailing Address - Street 2:SUITE 320
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6549
Mailing Address - Country:US
Mailing Address - Phone:815-725-4367
Mailing Address - Fax:815-725-4863
Practice Address - Street 1:301 MADISON ST STE 300
Practice Address - Street 2:SUITE 320
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6549
Practice Address - Country:US
Practice Address - Phone:815-725-4367
Practice Address - Fax:815-725-4863
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1257982084N0400X
IL0361257982084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology