Basic Information
| Provider Information | |||||||||
| NPI: | 1669916367 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AKILEH | ||||||||
| FirstName: | NADI | ||||||||
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| Credential: | DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25309 COLLIGAN ST | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604421417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086683534 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25309 COLLIGAN ST | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604421417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086683534 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2016 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 041401444 | IL | N | Nursing Service Providers | Registered Nurse | 367500000X | 209015470 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.