Provider Demographics
NPI:1841262961
Name:NADKARNI, NITIN (MD)
Entity type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:NADKARNI
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 1:2222 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60435-0928
Mailing Address - Country:US
Mailing Address - Phone:815-741-9719
Mailing Address - Fax:815-744-5137
Practice Address - Street 1:2222 WEBER RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60435-0928
Practice Address - Country:US
Practice Address - Phone:815-741-9719
Practice Address - Fax:815-744-5137
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36097009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist