Individual ProviderPrincy NinanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address183 N East River Rd Unit D6, Des Plaines, IL 60016-1286(847) 863-8323PECOS EnrollmentBased on the most recent information from CMS, provider Princy Ninan is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1659047579Provider TypeIndividualFull NameNinan, PrincyCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date8/19/2021Last Updated8/19/2021Contact InformationPractice LocationPractice Address183 N East River Rd Unit D6, Des Plaines, IL 60016-1286Phone(847) 863-8323FaxUnlisted FaxMailing LocationMailing Address183 N East River Rd Unit D6, Des Plaines, IL 60016-1286Phone(847) 863-8323FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209023825Illinois