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General NPI Number Information
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NPI Number | 1801760988
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Entity Type | Individual
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Provider Name | NIMISHA EDUKU
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 100 N RIVER RD
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City | DES PLAINES
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State | IL
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Zip | 60016-1209
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Country | US
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Telephone | 847-297-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 234 W POLK ST UNIT 3104
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City | CHICAGO
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State | IL
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Zip | 60607-3224
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209.033231
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License Number State | IL
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