Healthcare Provider Details

I. General information

NPI: 1215665120
Provider Name (Legal Business Name): SANDIP NIJJAR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD STE 405
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

25 N WINFIELD RD STE 405
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4448
  • Fax: 630-315-6290
Mailing address:
  • Phone: 630-933-4448
  • Fax: 630-315-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209026011
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: