Active NPI
Nab MD SC
- Geriatric Medicine (Internal Medicine) Physician
- Roselle, IL
National Provider Identifier
1174590624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- Legal business name
- NAB MD SC
- Practice address
- 400 W Lake St
Suite 111a
Roselle, IL 60172 - Phone
- (630) 893-8300
- Fax
- (630) 893-8324
- NPI assigned
- Mar 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nelson Arthur Blanco, MD
- Title
- President
- Phone
- (630) 893-8300
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | Primary |
Addresses
Primary practice location
400 W Lake St
Suite 111a
Roselle, IL 60172
Mailing address
400 W Lake St
Suite 111a
Roselle, IL 60172
Phone (630) 893-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210043 | Other | WPS GROUP # |
National Provider Directory
National Provider DirectoryLocations
550 Thornhill Dr
Carol Stream, IL 60188
Phone (630) 682-9000
400 Lake St
Ste 212
Roselle, IL 60172
Phone (630) 893-8300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Joliet, IL
- NPI 1265618870
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1174590624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W LAKE ST",
"address_2": "SUITE 111A",
"city": "ROSELLE",
"state": "IL",
"postal_code": "60172",
"telephone_number": "630-893-8300",
"fax_number": "630-893-8324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W LAKE ST",
"address_2": "SUITE 111A",
"city": "ROSELLE",
"state": "IL",
"postal_code": "60172",
"telephone_number": "630-893-8300",
"fax_number": "630-893-8324"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NAB MD SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-03",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BLANCO",
"authorized_official_first_name": "NELSON",
"authorized_official_middle_name": "ARTHUR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-893-8300",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS GROUP #",
"identifier": "210043",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roselle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.