MEDICARE: DR. NILAM KIRAN AMIN D.O.

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	207N00000X	Dermatology Physician	036-115389	IL

General Provider Information

NPI Number	:	1619907995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILAM KIRAN AMIN D.O.

Provider Business Mailing Address
First Line	:	1460 N HALSTED ST
Second Line	:	SUITE #505
City	:	CHICAGO
State	:	IL
Zip	:	60642-2605
Country	:	US
Telephone Number	:	312-266-6462
Fax Number	:	312-266-6481

Provider Business Practice Location Address
First Line	:	1460 N HALSTED ST
Second Line	:	SUITE #505
City	:	CHICAGO
State	:	IL
Zip	:	60642-2605
Country	:	US
Telephone Number	:	312-266-6462
Fax Number	:	312-266-6481

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/22/2021

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