Provider Demographics
NPI:1710931621
Name:VERMA, NIRMLA (MD)
Entity Type:Individual
Prefix:
First Name:NIRMLA
Middle Name:
Last Name:VERMA
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 1:1555 W HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1707
Mailing Address - Country:US
Mailing Address - Phone:773-764-7146
Mailing Address - Fax:773-764-3774
Practice Address - Street 1:1555 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1707
Practice Address - Country:US
Practice Address - Phone:773-764-7146
Practice Address - Fax:773-764-3774
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-111409208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
367830Medicare PIN
I22526Medicare UPIN