Basic Information
| Provider Information | |||||||||
| NPI: | 1396134078 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NESBIT | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 E SUPERIOR ST STE LC-2101 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129262520 | ||||||||
| FaxNumber: | 3124724439 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 E SUPERIOR ST STE LC-2101 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129262520 | ||||||||
| FaxNumber: | 3124724439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2015 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085R0001X | 125069737 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 036155649 | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.