Nittor R. Jayaram MD LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036056518 Issued in IL

Legal business name

NITTOR R. JAYARAM MD LTD

Practice address

17031 Harlem Ave
Tinley Park, IL 60477-2739

Phone

(708) 532-4200

Fax

(708) 532-9465

NPI assigned

Oct 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nittor R Jayaram, MD

Title

President

Phone

(708) 532-4200

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1356641120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17031 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-532-4200",
            "fax_number": "708-532-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17031 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772739",
            "telephone_number": "708-532-4200",
            "fax_number": "708-532-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NITTOR R. JAYARAM MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "JAYARAM",
        "authorized_official_first_name": "NITTOR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-532-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036056518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360565918",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Brian Nicholas, PSYD
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• Internal Medicine Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.