Healthcare Provider Details

I. General information

NPI: 1275461675
Provider Name (Legal Business Name): NILE ANTONY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

IV. Provider business mailing address

600 HATLEN AVE
MOUNT PROSPECT IL
60056-3571
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041495700
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: