Provider Demographics
NPI:1134417553
Name:ATRI, NIPUN (MD)
Entity type:Individual
Prefix:DR
First Name:NIPUN
Middle Name:
Last Name:ATRI
Suffix:
Gender:M
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:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2923 N CALIFORNIA AVE
Practice Address - Street 2:STE 220
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7702
Practice Address - Country:US
Practice Address - Phone:773-205-4660
Practice Address - Fax:773-205-7654
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139727207R00000X, 207RI0200X
CODR.0070012207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL010036139727Medicaid
ILF400287696Medicare PIN
ILF400287695Medicare PIN
ILF400287693Medicare PIN
IL010036139727Medicaid