MEDICARE: MARY ELLEN BOYTE D.N.

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	133N00000X	Nutritionist
2	174H00000X	Health Educator
3	133NN1002X	Nutrition Education Nutritionist
4	174400000X	Specialist
5	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	181000276	IL
6	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	181000276	IL
7	208100000X	Physical Medicine & Rehabilitation Physician	181000276	IL
8	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	181000276	IL
9	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	181000276	IL
10	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	181000276	IL
11	2083S0010X	Sports Medicine (Preventive Medicine) Physician	181000276	IL
12	208VP0000X	Pain Medicine Physician	181000276	IL
13	172P00000X	Naprapath	172P00000X	IL

General Provider Information

NPI Number	:	1487980470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELLEN BOYTE D.N.

Provider Business Mailing Address
First Line	:	389 OXFORD RD
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-3015
Country	:	US
Telephone Number	:	773-550-7241
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4001
Country	:	US
Telephone Number	:	773-282-2686
Fax Number	:	773-282-2688

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

Provider Enumeration Date	:	10/26/2009
Last Update Date	:	09/03/2021

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