Healthcare Provider Details

I. General information

NPI: 1649228701
Provider Name (Legal Business Name): NATHAN R JAISINGH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1938 E LINCOLN HWY STE 207B
NEW LENOX IL
60451-3810
US

IV. Provider business mailing address

1938 E LINCOLN HWY STE 207B
NEW LENOX IL
60451-3810
US

V. Phone/Fax

Practice location:
  • Phone: 800-461-9533
  • Fax: 708-478-1302
Mailing address:
  • Phone: 800-461-9533
  • Fax: 708-478-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-004600
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9581526
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0376062-34
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041-322947
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: