Healthcare Provider Details

I. General information

NPI: 1992201180
Provider Name (Legal Business Name): LINDSAY D. NOWAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W HARRISON ST
CHICAGO IL
60612-3801
US

IV. Provider business mailing address

RUSH UNIVERSITY MEDICAL CENTER,DEPARTMENT OF ANESTHESIA 1653 W. CONGRESS PARKWAY, 739 JELKE-SOUTHCENTER
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax:
Mailing address:
  • Phone: 312-942-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberT9763
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036.169249
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: