Maimanat Nizam
Family Doctor - Adult Medicine
2001 W 69th St
Chicago
, Illinois 60636-3262
Maimanat Nizam
Family Doctor - Adult Medicine
2001 W 69th St
Chicago
, Illinois 60636-3262
(630) 654-1021
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Maimanat Nizam
- 401 Tamerton Pkwy
- Burr Ridge, IL
- Zip : 60527-6347
- Phone : (630) 654-1021
Second Address
- Maimanat Nizam
- 2001 W 69th St
- Chicago, IL
- Zip : 60636-3262
- Fax : (773) 778-2355
- Phone : (773) 778-2355
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 036-069635 | IL |
National Provider Identifier
| NPI | 1265579262 |
|---|---|
| Provider Name | Maimanat Nizam |
| First Address | Burr Ridge, IL 60527-6347 |
| Second Address | Chicago, IL 60636-3262 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/01/2007 |
| Last Update Date | 13/06/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036069635 | (05) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.