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Individual

ELIOT M NISSENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1102 N COUNTY ROAD 700, WARSAW, IL 62379-3011
(217) 256-4100
(217) 256-3800
Mailing address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 224-6423
(217) 221-1344

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-135963
IL
207RC0000X
Cardiovascular Disease Physician
Primary
2005000792
MO

Other

Enumeration date
06/16/2006
Last updated
11/27/2023
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