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Individual

DR. NICHOLAS IDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2615 N FORREST LN, ARLINGTON HEIGHTS, IL 60004-2241

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041409236
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209026518
IL

Other

Enumeration date
10/27/2022
Last updated
12/16/2025
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