Individual
LIANA BORISOVNA NISIMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
259 E ERIE ST STE 2150, CHICAGO, IL 60611-3370
(312) 926-3627
(312) 926-3858
Mailing address
259 E ERIE ST STE 2150, CHICAGO, IL 60611-3370
(312) 926-3627
(312) 926-3858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036152905
IL
Other
Enumeration date
04/21/2016
Last updated
09/25/2020
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