Provider Demographics
NPI:1811951411
Name:AGGARWAL, NIMIT K (MD)
Entity type:Individual
Prefix:
First Name:NIMIT
Middle Name:K
Last Name:AGGARWAL
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 1:12820 S RIDGELAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2388
Mailing Address - Country:US
Mailing Address - Phone:708-371-8006
Mailing Address - Fax:708-389-6630
Practice Address - Street 1:12820 S RIDGELAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2388
Practice Address - Country:US
Practice Address - Phone:708-371-8006
Practice Address - Fax:708-389-6630
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097747207RC0200X, 174400000X
IL036-097747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632457OtherBLUE CROSS BLUE SHIELD
ILP00246126OtherRAILROAD MEDICARE
IL036097747Medicaid
ILP00246126OtherRAILROAD MEDICARE