Provider Demographics
NPI:1851548127
Name:GOLEWALE, NAZAR (MD)
Entity type:Individual
Prefix:DR
First Name:NAZAR
Middle Name:
Last Name:GOLEWALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3813
Mailing Address - Country:US
Mailing Address - Phone:574-334-0336
Mailing Address - Fax:574-258-1101
Practice Address - Street 1:8127 MERRILLVILLE RD STE 1B
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6306
Practice Address - Country:US
Practice Address - Phone:574-258-1100
Practice Address - Fax:574-258-1101
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069831A2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201024390Medicaid
IN201024390Medicaid