Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 036104366 | IL |
Y | 207RP1001X | Pulmonary Disease | 036104366 | IL |
N | 207RS0012X | Sleep Medicine | 036104366 | IL |
NPI | 1003883463 |
---|---|
Provider Name | Ravi Nemivant |
First Address | Chicago, IL 60674-0018 |
Second Address | Naperville, IL 60540-6550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 23/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036104366 | (05) | IL |