Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ELIOT M NISSENBAUM, DO
ActiveELIOT M NISSENBAUM, DO is a Cardiovascular Disease healthcare provider located in WARSAW, Illinois. NPI 1326082454 is currently active in the NPPES registry. Verify at CMS.
Cardiovascular Disease · WARSAW, IL
Registration Details
- NPI Number
- 1326082454
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 16, 2006 (20.189336087153 yrs)
- Last Updated
- Nov 27, 2023
- Licenses
-
036-135963 (IL)2005000792 (MO)
Practice Information
- Address
-
1102 N COUNTY ROAD 700WARSAW, IL, 623793011Browse IL providers · Browse ZIP 62379
- Phone
- 2172564100
- Fax
- 2172563800
- Primary Specialty
-
Cardiovascular Disease
207RC0000X
- Additional Specialty
- Cardiovascular Disease
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.