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Individual

NATHAN M KAKISH

Active
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Individual

NATHAN M KAKISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-116194
IL
208000000X
Pediatrics Physician
036-116194
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116194 1
—
IL
01
—
1518975309
BCBSWI
WI
05
—
1518975309
—
WI
01
—
KAKISNAT
MERCYCARE INSURANCE
WI
Enumeration date
08/04/2006
Last updated
09/14/2020
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