Individual
ANISHA NANDYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2320 E 93RD ST, CHICAGO, IL 60617-3909
(773) 967-2000
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1842
(847) 390-5900
(608) 364-5452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-148668
IL
208M00000X
Hospitalist Physician
Primary
69886-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080654
—
WI
Enumeration date
04/13/2015
Last updated
09/20/2024
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