Provider Demographics
NPI:1780205104
Name:ARAVIND, NIVETA (MD)
Entity type:Individual
Prefix:DR
First Name:NIVETA
Middle Name:
Last Name:ARAVIND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIVETA
Other - Middle Name:
Other - Last Name:SUBBIAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8388 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2400
Mailing Address - Country:US
Mailing Address - Phone:214-600-3885
Mailing Address - Fax:
Practice Address - Street 1:1620 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3801
Practice Address - Country:US
Practice Address - Phone:214-600-3885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015079582084N0400X
390200000X
IL0361707932084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program