Provider Demographics
NPI:1689733552
Name:PALEOLOGOS, NINA A (MD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:A
Last Name:PALEOLOGOS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1875 DEMPSTER ST STE 625
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1137
Mailing Address - Country:US
Mailing Address - Phone:847-723-4088
Mailing Address - Fax:
Practice Address - Street 1:3825 HIGHLAND AVE STE 303
Practice Address - Street 2:ADVOCATE MEDICAL GROUP DOWNERS GROVE HIGHLAND AVENUE
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1562
Practice Address - Country:US
Practice Address - Phone:844-376-3876
Practice Address - Fax:630-929-6063
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360742782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E19050Medicare UPIN