David A Nellessen, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-071727 Issued in IL

Practice address

2101 S Arlington Heights Rd
#108
Arlington Heights, IL 60005-4185

Phone

(847) 439-4343

Fax

(847) 439-4510

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northwest Urological Associates, S.C.

  • Specialist
  • Arlington Heights, IL
  • NPI 1851489751
  NPD Authorized official
• United Shockwave Services, LTD.

  • Ambulatory Surgical Clinic/Center
  • La Grange, IL
  • NPI 1336526219
  NPD
• United Shockwave Services, LTD.

  • Urology Physician
  • Park Ridge, IL
  • NPI 1497132377
  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1306934278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S ARLINGTON HEIGHTS RD",
            "address_2": "#108",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054185",
            "telephone_number": "847-439-4343",
            "fax_number": "847-439-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S ARLINGTON HEIGHTS RD",
            "address_2": "#108",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054185",
            "telephone_number": "847-439-4343",
            "fax_number": "847-439-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLESSEN",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-071727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-071727",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shah Nawaz, M.D.
• Vidhi Nayi
• NCH Service Company LLC
• NCH Service Company LLC
• Jay S Neidich, M.A., CCC-SLP
• Gregory Nelson
• Haley Nelson
• Heather R Nelson, DNP
• Karen Nelson, APN-CRNA
• Kristen Carole Nelson

• Specialist in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.