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General NPI Number Information
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NPI Number | 1144486721
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Entity Type | Individual
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Provider Name | REJI NINAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2008
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1300 N ARLINGTON HEIGHTS RD STE 130
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City | ITASCA
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State | IL
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Zip | 60143-3128
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Country | US
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Telephone | 847-871-4540
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Fax | 847-871-4597
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Provider Business Mailing Address
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Address Line | POB 7132960
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City | CHICAGO
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State | IL
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Zip | 60677-0001
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Country | US
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Telephone | 630-469-9200
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-126994
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License Number State | IL
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