Healthcare Provider Details

I. General information

NPI: 1760546469
Provider Name (Legal Business Name): SHARMILEE M NYENHUIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARMILEE M CHUGH M.D.

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W TAYLOR ST SUITE 3C MC755
CHICAGO IL
60612-4795
US

IV. Provider business mailing address

840 S WOOD ST MC 719 920N CSB
CHICAGO IL
60612-4325
US

V. Phone/Fax

Practice location:
  • Phone: 312-413-2088
  • Fax: 312-996-3896
Mailing address:
  • Phone: 312-413-1655
  • Fax: 312-996-4665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number49275
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036.114534
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: