Nahd SC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NAHD SC

Practice address

7402 E Riverside Blvd
Loves Park, IL 61111-5630

Phone

(815) 226-9642

Fax

(815) 226-9672

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Ann Hartsough, MD

Title

Owner

Phone

(815) 226-9642

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hartsough Dermatology Doing business as

Locations

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1881695468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 E RIVERSIDE BLVD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115630",
            "telephone_number": "815-226-9642",
            "fax_number": "815-226-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 E RIVERSIDE BLVD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115630",
            "telephone_number": "815-226-9642",
            "fax_number": "815-226-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAHD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "HARTSOUGH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-226-9642",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEMBER #",
            "identifier": "K170159",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hartsough Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Morris, LCSW
• John Herrmann Mueller, MD
• Malynnda A. Mueller, C.R.N.A.
• Mulford Eye Care LLC
• Kinda Muslemani, M.D.
• Aliya S. Naseer, MD
• Mary Naugle, LCPC, LCSW
• Momin Nauman, MBBS
• Michael Brad Nemsick, MD
• Kelsey A Newman, CRNA

• Specialist in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.