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General NPI Number Information
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NPI Number | 1346341336
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Entity Type | Organization
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Legal Business Name | R DEVA NATHAN MD SC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 3800 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2718
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Country | US
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Telephone | 773-205-8415
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Fax | 773-205-8436
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Provider Business Mailing Address
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Address Line | 3800 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2718
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Country | US
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Telephone | 773-205-8415
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Fax | 773-205-8436
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Authorized Official
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Title or Position | MD PRESIDENT
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Name | R DEVA NATHAN
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Credential | MD
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Telephone | 773-205-8415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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