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General NPI Number Information
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NPI Number | 1003833070
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Entity Type | Individual
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Provider Name | NITIN NARENDIR SOORYA MD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 1420 BUSSE ROAD
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007
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Country | US
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Telephone | 847-653-0142
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Fax | 847-621-2255
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Provider Business Mailing Address
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Address Line | 1590 W ALGONQUIN RD # 112
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-1575
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Country | US
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Telephone | 847-899-6999
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Fax | 847-787-1784
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036104394
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-104394
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License Number State | IL
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