Provider Demographics
NPI:1497835219
Name:SULTANIAN, NINA M (MD)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:M
Last Name:SULTANIAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2140 DOWNEY ROAD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3630
Mailing Address - Country:US
Mailing Address - Phone:708-957-7183
Mailing Address - Fax:847-228-7640
Practice Address - Street 1:2015 SOUTH ARLINGTON HEIGHTS ROAD SUITE # 103
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-228-7600
Practice Address - Fax:847-228-7641
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632133OtherBLUE CROSS BLUE SHIELD
IL7104492OtherCIGNA
IL7104492OtherCIGNA
G13601Medicare UPIN