Individual
DORIS F NUSSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-8080
(847) 723-4378
Mailing address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-8080
(847) 723-4378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0036097971
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097971
—
IL
Enumeration date
07/15/2006
Last updated
12/18/2021
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