MEDICARE: NAJIB NASSANI 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
1	207RG0100X	Gastroenterology Physician	35C.003737	OH
2	207RG0100X	Gastroenterology Physician	036145278	IL
3	207R00000X	Internal Medicine Physician	036145278	IL

General Provider Information

NPI Number	:	1477935807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAJIB NASSANI M.D.

Provider Business Mailing Address
First Line	:	611 W PARK ST
Second Line	:
City	:	URBANA
State	:	IL
Zip	:	61801-2501
Country	:	US
Telephone Number	:	217-902-6954
Fax Number	:	217-902-7711

Provider Business Practice Location Address
First Line	:	611 W PARK
Second Line	:	FAPC
City	:	URBANA
State	:	IL
Zip	:	61802
Country	:	US
Telephone Number	:	217-902-6954
Fax Number	:	217-902-7711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	03/05/2026

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