MEDICARE: DR. NICOLAI E HINDS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	036124124	IL
2	207V00000X	Obstetrics & Gynecology Physician	036124124	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124024161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLAI E HINDS M.D.

Provider Business Mailing Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-653-4240
Fax Number	:	630-315-6597

Provider Business Practice Location Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-653-4240
Fax Number	:	630-315-6597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	11/08/2021

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