Healthcare Provider Details

I. General information

NPI: 1548532526
Provider Name (Legal Business Name): NIHON MEDICAL CLINIC, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 S ARLINGTON HEIGHTS RD SUITE 101
ARLINGTON HEIGHTS IL
60005-4134
US

IV. Provider business mailing address

2010 S ARLINGTON HEIGHTS ROAD SUITE 101
ARLINGTON HEIGHTS IL
60005-4100
US

V. Phone/Fax

Practice location:
  • Phone: 847-952-8910
  • Fax: 847-952-0606
Mailing address:
  • Phone: 847-952-8910
  • Fax: 847-952-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name: DR. HIDEKI SHIKATA
Title or Position: PRESIDENT
Credential: MD
Phone: 847-952-8910