MEDICARE: MR. NYAMBI EBIE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	036045826	IL
2	207RX0202X	Medical Oncology Physician	036045826	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1548234883	OTHER	IL	NPI - INDIVIDUAL
2	200165450A	OTHER	IN	PUBLIC AID - INDIANA
3	226920	OTHER	IN	INDIANA PTAN - INDIVIDUAL- NYAMBI EBIE
4	0001634652	OTHER	IL	BCBS - IL
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	IN1034	OTHER	IN	INDIANA PTAN ( GROUP ) CMGI
7	1376505065	OTHER		CMGI NPI (GROUP)
8	201129370A	OTHER	IN	INDIANA PROVIDER # ( GROUP ) CMGI
9	K15828	OTHER	IL	LEGACY NUMBER
10	210946	OTHER	IL	ILLINOIS PTAN ( GROUP) CMGI
11	000000347617	OTHER	IN	ANTHEM- BCBS- INDIANA
12	P00190421	OTHER	IL	RAILROAD - IL
13	P00285036	OTHER	IN	RAILROAD INDIANA

General Provider Information

NPI Number	:	1548234883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NYAMBI EBIE MD

Provider Business Mailing Address
First Line	:	505 N LAKE SHORE DR
Second Line	:	SUITE 5811
City	:	CHICAGO
State	:	IL
Zip	:	60611-3427
Country	:	US
Telephone Number	:	773-731-2982
Fax Number	:	773-731-3328

Provider Business Practice Location Address
First Line	:	2301 E 93RD ST
Second Line	:	SUITE 110
City	:	CHICAGO
State	:	IL
Zip	:	60617-3913
Country	:	US
Telephone Number	:	773-731-2982
Fax Number	:	773-731-3328

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	05/21/2024

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