Individual
DR. NICHOLAS NAYAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2010 JACOBSSEN DR, NORMAL, IL 61761-6280
(309) 452-0995
(309) 862-0961
Mailing address
2010 JACOBSSEN DR, NORMAL, IL 61761-6280
(309) 452-0995
(309) 862-0961
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
36067066
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732039
BCBS OF ILLINOIS
IL
Enumeration date
11/01/2006
Last updated
07/08/2007
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