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Individual
NEIL R NELSON
Active
Individual
NEIL R NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085035
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085035 1
—
IL
05
—
363964866001 1
—
IL
01
—
IL5248
NGS
IL
Enumeration date
08/26/2005
Last updated
09/26/2013
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