Healthcare Provider Details

I. General information

NPI: 1861012858
Provider Name (Legal Business Name): NICOLE ANISHA SOMANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANISHA NICOLE SOMANI MD

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 DONALD S POWERS DR STE 101A
MUNSTER IN
46321-4071
US

IV. Provider business mailing address

200 HAWKINS DR UNIT 10915
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 219-922-9888
  • Fax: 219-922-9088
Mailing address:
  • Phone: 319-356-3705
  • Fax: 319-353-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number036181199
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number01100577A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036181199
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number01100577A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: