SearchIllinois122300000X

Robert Nidea

NPI 1790845725 · on the registry since 2006

Practice

Address
16280 Prince Dr
South Holland, IL 60473
Phone
(708) 225-1866
Organisation at this address
Infinity Smile Ltd
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
122300000X
122300000X
Also registered as
1223G0001X
Licence states on file
TX, IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-08-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois