Provider Demographics
NPI:1194012260
Name:LATH, NIKESH (MD)
Entity type:Individual
Prefix:DR
First Name:NIKESH
Middle Name:
Last Name:LATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1890 SILVER CROSS BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9547
Mailing Address - Country:US
Mailing Address - Phone:815-717-8730
Mailing Address - Fax:815-717-8729
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 410
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9547
Practice Address - Country:US
Practice Address - Phone:815-717-8730
Practice Address - Fax:815-717-8729
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2025-11-13
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Provider Licenses
StateLicense IDTaxonomies
IL036-138440208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery