Healthcare Provider Details

I. General information

NPI: 1972133080
Provider Name (Legal Business Name): LOUIS NIKOLIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST FL 13
CHICAGO IL
60611-3926
US

IV. Provider business mailing address

259 E ERIE ST FL 13
CHICAGO IL
60611-3926
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-6800
  • Fax: 312-472-4872
Mailing address:
  • Phone: 312-695-6800
  • Fax: 312-472-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036181467
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA201329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: