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Organization
NANI INTERNAL MED LLC
Active
Organization
NANI INTERNAL MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANISH TANNA (PRESIDENT)
(630) 573-5000
Entity
Organization
Contact information
Practice address
6438 JOLIET RD STE 203, COUNTRYSIDE, IL 60525-4624
(708) 352-5222
Mailing address
120 W 22ND ST, OAK BROOK, IL 60523-1557
(630) 974-5216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
09/26/2018
Last updated
11/21/2024
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