Provider Demographics
NPI:1619907995
Name:AMIN, NILAM KIRAN (DO)
Entity Type:Individual
Prefix:DR
First Name:NILAM
Middle Name:KIRAN
Last Name:AMIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1460 N HALSTED ST
Mailing Address - Street 2:SUITE #505
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2605
Mailing Address - Country:US
Mailing Address - Phone:312-266-6462
Mailing Address - Fax:312-266-6481
Practice Address - Street 1:1460 N HALSTED ST
Practice Address - Street 2:SUITE #505
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2605
Practice Address - Country:US
Practice Address - Phone:312-266-6462
Practice Address - Fax:312-266-6481
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115389207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology