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NPI Code Detail

MEDICARE: DR. REJI NINAN M.D.

MEDICARE: DR. REJI NINAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036-126994IL

General Provider Information

NPI Number : 1144486721
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REJI NINAN M.D.
Provider Business Mailing Address
First Line : POB 7132960
Second Line :
City : CHICAGO
State : IL
Zip : 60677-0001
Country : US
Telephone Number : 630-469-9200
Fax Number :
Provider Business Practice Location Address
First Line : 1300 N ARLINGTON HEIGHTS RD STE 130
Second Line :
City : ITASCA
State : IL
Zip : 60143-3128
Country : US
Telephone Number : 847-871-4540
Fax Number : 847-871-4597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2008
Last Update Date : 07/18/2025

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Directions to “ DR. REJI NINAN M.D.” Practice Location

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