Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036091089 | IL |
NPI | 1003823212 |
---|---|
Provider Name | John W Nikoleit |
First Address | Elmhurst, IL 60126-5017 |
Second Address | Elmhurst, IL 60126-5017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 20/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036091089 | (05) | IL |
G32064 | (02) | IL |