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NPI Code Detail

MEDICARE: DAISY NIE MD

MEDICARE:   DAISY  NIE  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
12084P0800XPsychiatry Physician036.146837IL

General Provider Information

NPI Number : 1164841722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISY NIE MD
Provider Business Mailing Address
First Line : 1440 RENAISSANCE DR STE 320
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-1471
Country : US
Telephone Number : 312-298-9780
Fax Number : 224-985-2119
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 1120
Second Line :
City : CHICAGO
State : IL
Zip : 60601-4001
Country : US
Telephone Number : 847-759-9110
Fax Number : 224-985-2119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 08/23/2022

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Directions to “ DAISY NIE MD” Practice Location

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