NICHOLAS J NIKITAS (NPI# 1659310753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659310753 |
| Entity Type | Individual |
| Full Name | NICHOLAS J NIKITAS |
| Credential | M.D. |
| Practice Address |
103 S Greenleaf St Suite J Gurnee IL 60031-3380 |
| Mailing Address |
2650 Ridge Ave Evanston Hospital Rm 1210 Evanston IL 60201-1718 |
| Practice Telephone | 8475998899 |
| Practice Fax Number | 8475998997 |
| Mailing Telephone | 8475701206 |
| Mailing Fax Number | 8475701248 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
103 S GREENLEAF ST SUITE J |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-3380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518959329 | Mathangi R Sekharan | Internal Medicine | 103 S Greenleaf St, Suite A, Gurnee, IL 60031-3380 | 2005-08-17 |
| 1093237596 | Joshua Nathan Riegelhaupt | Podiatrist | 103 S Greenleaf St, Ste B, Gurnee, IL 60031-3380 | 2017-07-17 |
| 1932539459 | Robert A. Hozman Md Sc | Internal Medicine | 103 S Greenleaf St, Suite J, Gurnee, IL 60031-3380 | 2013-11-19 |
| 1720203789 | Nickole A. Dooley | Family Medicine | 103 S Greenleaf St, Suite J, Gurnee, IL 60031-3380 | 2007-04-16 |
| 1639218944 | John Edward Stuparitz | Dentist | 103 S Greenleaf St, Suite K, Gurnee, IL 60031-3380 | 2007-02-05 |
| 1356495030 | Benjamin A Dubin | Specialist | 103 S Greenleaf St, Suite J, Gurnee, IL 60031-3380 | 2007-01-22 |
| 1699874511 | Diane B. Zimmerman | Physician Assistant | 103 S Greenleaf St, Suite J, Gurnee, IL 60031-3380 | 2006-09-21 |
| 1558316281 | Samuel Solomon | Specialist | 103 S Greenleaf St, Suite J, Gurnee, IL 60031-3380 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871548875 | Joseph Olinger | Family Medicine | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3336 | 2006-05-24 |
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|---|---|---|---|---|
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| 1699277038 | Eileen A Solis | Family Medicine | 1795 Grandstand Pl Ste 2, Elgin, IL 60123-4980 | 2018-03-01 |
| 1841703584 | Home Physicians of Illinois LLC | Family Medicine | 10027 Frontage Rd, Skokie, IL 60077-1033 | 2017-11-15 |
| 1770953986 | Mrs Integrative Medicine LLC | Family Medicine | 3s630 Glen Dr S, Warrenville, IL 60555-3506 | 2015-09-30 |
| 1447666318 | M & F Medical Services, Ltd | Family Medicine | 5642 N Christiana Ave, Chicago, IL 60659-4555 | 2014-07-10 |
| 1457767774 | Rambha Radhakrishnan | Family Medicine | 2645 W Peterson Ave, Chicago, IL 60659-4017 | 2014-07-08 |
| 1851733133 | Pyramids Advisors, Inc. | Family Medicine | 6427 Dempster St, Morton Grove, IL 60053-2604 | 2013-07-26 |
| 1558707075 | Jean M. Pouget | Family Medicine | 175 Northgate Rd, Riverside, Riverside, IL 60546-1683 | 2013-05-13 |
| 1629411806 | Rahman Fazil Mohammed Abdul | Family Medicine | 9011 W Ballard Rd Apt 1a, Des Plaines, IL 60016-4987 | 2013-04-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.