Provider Demographics
NPI:1487774782
Name:NISAR, NIGHAT (MD)
Entity type:Individual
Prefix:DR
First Name:NIGHAT
Middle Name:
Last Name:NISAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 CENTER ST
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2106
Mailing Address - Country:US
Mailing Address - Phone:847-931-4200
Mailing Address - Fax:847-931-4217
Practice Address - Street 1:915 CENTER ST
Practice Address - Street 2:SUITE 2001
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2106
Practice Address - Country:US
Practice Address - Phone:847-931-4200
Practice Address - Fax:847-931-4217
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH62197Medicare UPIN
ILK21785Medicare ID - Type UnspecifiedPROVIDER #