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NAB MD SC NPI 1174590624


NPI Information

NPI: 1174590624
Provider Name: NAB MD SC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
400 W LAKE ST
SUITE 111A
ROSELLE, IL
ZIP 60172
Phone: (630) 893-8300
Get Directions

NAB MD SC is a geriatric medicine internal medicine in Roselle, IL. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. NAB MD SC NPI is 1174590624. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

400 W LAKE ST
SUITE 111A
ROSELLE, IL
ZIP 60172
Phone: (630) 893-8300
Fax: (630) 893-8324

The provider's authorized official is Nelson Arthur Blanco .
The authorized official title is President and has the following contact phone number (630) 893-8300.

The enumeration date for this NPI number is 3/3/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric MedicineYes
2207R00000XInternal MedicineX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1210043OTHERWPS GROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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