Individual
BORISLAV M NIKOLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 W WILSON AVE APT 1, CHICAGO, IL 60625-3678
(717) 969-0051
Mailing address
2450 W WILSON AVE APT 1, CHICAGO, IL 60625-3678
(717) 969-0051
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036103283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103283
—
IL
01
—
10593690
CAQH
—
01
—
364271985-23
JOHN DEERE
—
01
—
4815127
BC/BS
—
Enumeration date
09/26/2006
Last updated
11/27/2023
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