Provider Demographics
NPI:1275339442
Name:BAROT, NIDHI RAVI (OD)
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:RAVI
Last Name:BAROT
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:NIDHI
Other - Middle Name:RAJESH
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:POB 7132960
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-0001
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:303 E ARMY TRAIL RD STE 200
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2143
Practice Address - Country:US
Practice Address - Phone:630-351-2030
Practice Address - Fax:630-351-3983
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011960152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist