Provider Demographics
NPI:1790247492
Name:MONK, IAN NIGEL (MD)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:NIGEL
Last Name:MONK
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 1:111 E CHESTNUT ST APT 18K
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2088
Mailing Address - Country:US
Mailing Address - Phone:331-688-2480
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-3239
Practice Address - Country:US
Practice Address - Phone:631-444-2119
Practice Address - Fax:631-444-8886
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336079207RG0100X
IL036.160069207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty