Individual
NISSIM STOLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
2652 W GREENLEAF AVE, APT #2, CHICAGO, IL 60645-3208
(773) 701-2085
Mailing address
9332 TRIPP AVE APT 2, SKOKIE, IL 60076-1457
(773) 701-2085
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036157013
IL
2080P0216X
Pediatric Rheumatology Physician
Primary
036157013
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2015
Last updated
03/21/2025
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