Provider Demographics
NPI:1609139120
Name:PINTO, NISHA (MD)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:PINTO
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 1:230 E ONTARIO ST APT 2403
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-7261
Mailing Address - Country:US
Mailing Address - Phone:248-688-8698
Mailing Address - Fax:
Practice Address - Street 1:230 E ONTARIO ST APT 2403
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-7261
Practice Address - Country:US
Practice Address - Phone:248-688-8698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125062116207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology