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Individual

DR. NITTOR R JAYARAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15300 WEST AVE, ORLAND PARK, IL 60462-4600
(708) 403-8400
(708) 403-8492
Mailing address
12251 S 80TH AVE, SUITE 1630, PALOS HEIGHTS, IL 60463-1256
(708) 923-5173
(708) 923-5018

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036.056518
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036056518
IL
01
F400380350
MEDICARE PTAN
IL
Enumeration date
11/07/2006
Last updated
11/29/2021
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