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General NPI Number Information
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NPI Number | 1649228701
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Entity Type | Individual
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Provider Name | NATHAN R JAISINGH NP
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 11231 DISTINCTIVE DR
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City | ORLAND PARK
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State | IL
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Zip | 60467-9458
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Country | US
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Telephone | 708-460-9833
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Fax | 708-460-1117
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Provider Business Mailing Address
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Address Line | PO BOX 379
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City | ORLAND PARK
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State | IL
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Zip | 60462-0379
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Country | US
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Telephone | 708-460-9833
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Fax | 708-460-1117
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041-322947
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-004600
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0376062-34
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License Number State | IL
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