Nino Usanetashvili, MD
Internal Medicine in Park Ridge, Illinois
1396867685- Practice location
- 1775 Dempster St Rm E592b, Park Ridge, IL 60068-1143
- Phone
- 847-723-8080
- Fax
- 847-723-4378
- Last updated
- September 15, 2022
Nino Usanetashvili is an Internal Medicine based in Park Ridge, IL. Nino Usanetashvili practices in Park Ridge, IL and has the professional credentials of MD. The NPI Number for Nino Usanetashvili is 1396867685 and holds a License No. 13647 (NH). The current practice location address for Nino Usanetashvili is 1775 Dempster St Rm E592b, Park Ridge, IL 60068-1143 and can be reached out via phone at 847-723-8080 and via fax at 847-723-4378.
Provider Profile Details
- NPI Number
- 1396867685
- Provider Name
- Nino Usanetashvili
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1775 Dempster St Rm E592b, Park Ridge, IL 60068-1143
- Phone Number
- 847-723-8080
- Fax Number
- 847-723-4378
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 6, 2007
- Last Update Date
- September 15, 2022
- Certification Date
- September 15, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1775 Dempster St Rm E592b
Park Ridge, IL 60068-1143 - City
- Park Ridge
- State
- Illinois
- Zip
- 60068-1143
- Phone Number
- 847-723-8080
- Fax Number
- 847-723-4378
Provider Business Mailing Address Details
- Address
- 29373 Network Pl
Chicago, IL 60673-1293 - City
- Chicago
- State
- IL
- Zip
- 60673-1293
- Phone Number
- 847-390-5900
- Fax Number
- 847-390-4757
License Information
- License Number (1)
- 13647
- License State (1)
- NH
- Taxonomy (1)
- Internal Medicine · 207R00000X
- License Number (2)
- 13647
- License State (2)
- NH
- Taxonomy (2)
- Hospitalist · 208M00000X
- License Number (3)
- 036.147400
- License State (3)
- IL
- Taxonomy (3)
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Nino Usanetashvili, MD?
The NPI number of Nino Usanetashvili, MD is 1396867685. It was assigned on April 6, 2007 and is currently active in the NPPES registry.
What is the specialty of Nino Usanetashvili, MD?
Nino Usanetashvili, MD is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in NH under license number 13647.
Where does Nino Usanetashvili, MD practice?
The practice location is 1775 Dempster St Rm E592b, Park Ridge, IL 60068-1143. The office can be reached at 847-723-8080 (phone) or 847-723-4378 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1396867685 directly on the NPPES registry website.