Healthcare Provider Details

I. General information

NPI: 1437199098
Provider Name (Legal Business Name): STEVEN M NAKISHER PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. STEVEN NAKISHER

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25857 CONCORD RD
HUNTINGTON WOODS MI
48070-1636
US

IV. Provider business mailing address

25857 CONCORD RD
HUNTINGTON WOODS MI
48070-1636
US

V. Phone/Fax

Practice location:
  • Phone: 312-519-9000
  • Fax: 312-755-7001
Mailing address:
  • Phone: 312-519-9000
  • Fax: 312-755-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071005565
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: