Provider Demographics
NPI:1023169570
Name:NILAM K. AMIN, D.O., S.C.
Entity type:Organization
Organization Name:NILAM K. AMIN, D.O., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NILAM
Authorized Official - Middle Name:KIRAN
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:312-266-6462
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115389207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty