Individual
DR. MARK RYAN NIKKEL
Active
Individual
DR. MARK RYAN NIKKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36100980
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-100980
STATE LICENSE NUMBER
IL
05
—
036100980
—
IL
01
—
1023138633
GROUP NPI NUMBER
IL
01
—
31622992
BCBS
IL
Enumeration date
09/27/2005
Last updated
11/27/2023
Update your record
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