Individual provider Active NPI

Indira Devi Nair, M.D., S.C.

  • Internal Medicine Physician
  • Niles, IL
National Provider Identifier
1306880455
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036067349 Issued in IL
Practice address
8565 W Dempster St
Niles, IL 60714-1472
Phone
(847) 873-9367
Fax
(224) 246-8127
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036067349 IL Primary

Addresses

Primary practice location

8565 W Dempster St
Niles, IL 60714-1472

Mailing address

8565 W Dempster St
Niles, IL 60714-1406
Phone (847) 873-9367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036067349ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Khushi Jenna Partnership, LLC Internal Medicine Past Accepting new patients
Doctor J M Moradia MD SC Internal Medicine PastSince Jan 1, 2001 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1306880455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8565 W DEMPSTER ST",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141406",
            "telephone_number": "847-873-9367",
            "fax_number": "847-518-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8565 W DEMPSTER ST",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141472",
            "telephone_number": "847-873-9367",
            "fax_number": "224-246-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "INDIRA",
        "middle_name": "DEVI",
        "name_prefix": "Dr.",
        "credential": "M.D., S.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.