Basic Information
Provider Information
NPI: 1003018995
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NIHILL
FirstName: PATRICIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.M.D., M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 0N622 BOWDISH DR
Address2:  
City: GENEVA
State: IL
PostalCode: 601343560
CountryCode: US
TelephoneNumber: 6307152821
FaxNumber:  
Practice Location
Address1: 949 W LIBERTY DR
Address2:  
City: WHEATON
State: IL
PostalCode: 601874846
CountryCode: US
TelephoneNumber: 6307152821
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2007
LastUpdateDate: 02/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X8537KYN Dental ProvidersDentist 
1223G0001X8537KYN Dental ProvidersDentistGeneral Practice
1223G0001X019018298ILY Dental ProvidersDentistGeneral Practice
1223P0700XDS 00870MON Dental ProvidersDentistProsthodontics

ID Information
IDTypeStateIssuerDescription
710004408005KY MEDICAID


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