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NPI Code Detail

MEDICARE: ANTHONY NELSON II NP

MEDICARE: ANTHONY NELSON II NP
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
12084A2900XNeurocritical Care Physician209.032404IL
2363LC0200XCritical Care Medicine Nurse Practitioner209.032404IL
3163W00000XRegistered Nurse041.538332IL

General Provider Information

NPI Number : 1568275337
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY NELSON II NP
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 4440 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2600
Country : US
Telephone Number : 708-684-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2025
Last Update Date : 01/26/2026

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