Provider Demographics
NPI:1457926669
Name:TIWARI, NISHANT RAJENDRA (MD)
Entity Type:Individual
Prefix:MR
First Name:NISHANT
Middle Name:RAJENDRA
Last Name:TIWARI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:LOYOLA MEDICINE MCNEAL HOSPITAL 3249 SOUTH OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402
Mailing Address - Country:US
Mailing Address - Phone:708-783-3401
Mailing Address - Fax:
Practice Address - Street 1:3722 SOUTH HARLEM AVE MCNEAL CENTER FOR INTERNAL MEDIC
Practice Address - Street 2:SUITE LL34
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546
Practice Address - Country:US
Practice Address - Phone:708-783-6566
Practice Address - Fax:708-783-6567
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125078151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine