Organization Active NPI

Nab MD SC

  • Geriatric Medicine (Internal Medicine) Physician
  • Roselle, IL
National Provider Identifier
1174590624
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
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

Updated by the provider on Sep 11, 2025

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
210043OtherWPS GROUP #

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.