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NPI Code Detail

MEDICARE: MADISON NISE

MEDICARE:   MADISON  NISE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1578426193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON NISE
Provider Business Mailing Address
First Line : 1801 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4795
Country : US
Telephone Number : 312-413-7500
Fax Number :
Provider Business Practice Location Address
First Line : 1801 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4795
Country : US
Telephone Number : 312-413-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ MADISON NISE ” Practice Location

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