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NPI Code Detail

MEDICARE: DR. NAYSON LUIS FERNANDES MD, MS

MEDICARE: DR. NAYSON LUIS FERNANDES MD, MS
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
12084N0400XNeurology PhysicianA206570CA

General Provider Information

NPI Number : 1649809484
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAYSON LUIS FERNANDES MD, MS
Provider Business Mailing Address
First Line : 912 S WOOD ST RM 174
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4300
Country : US
Telephone Number : 866-600-2273
Fax Number :
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 866-600-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 06/02/2026

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