Healthcare Provider Details

I. General information

NPI: 1871682393
Provider Name (Legal Business Name): NALINI T BIDANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S DAMEN AVE
CHICAGO IL
60612-3728
US

IV. Provider business mailing address

5121 S ELLIS AVE
CHICAGO IL
60615-3848
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-6655
  • Fax:
Mailing address:
  • Phone: 773-643-4191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number36-53978
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36-53978
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: