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NPI Code Detail

MEDICARE: DR. ARTHUR CHARLES NIELSEN III M.D.

MEDICARE:  DR. ARTHUR CHARLES NIELSEN III 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
12084P0800XPsychiatry PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10021609228OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1376550822
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ARTHUR CHARLES NIELSEN III M.D.
Provider Business Mailing Address
First Line : 333 E ONTARIO ST
Second Line : SUITE 4209B
City : CHICAGO
State : IL
Zip : 60611-4804
Country : US
Telephone Number : 312-649-0570
Fax Number : 847-441-7196
Provider Business Practice Location Address
First Line : 333 E ONTARIO ST
Second Line : SUITE 4209B
City : CHICAGO
State : IL
Zip : 60611-4804
Country : US
Telephone Number : 312-649-0570
Fax Number : 847-441-7196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ARTHUR CHARLES NIELSEN III M.D.” Practice Location

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