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Individual
MICHAEL E NENABER
Active
Individual
MICHAEL E NENABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036054063
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020057300
BLACK LUNG
IL
01
—
036054063
IL STATE LICENSE
IL
05
—
036054063
—
IL
01
—
060936
HEALTH ALLIANCE
IL
01
—
08421024
BC/BS
IL
01
—
101559
HEALTHLINK
IL
01
—
110201128
RR MEDICARE PIN
IL
01
—
133586700
ACS-OWCP
IL
01
—
14D0949277
CLIA
IL
01
—
170769
PERSONAL CARE
IL
01
—
371363944
IRS TAX ID
IL
01
—
6394P
CATERPILLAR
IL
01
—
CD7143
RR MEDICARE GROUP
IL
Enumeration date
08/08/2006
Last updated
06/13/2011
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