MEDICARE: DR. ELISE HYSER DO

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	207R00000X	Internal Medicine Physician	036.176254	IL
2	207RI0200X	Infectious Disease Physician	036176254	IL

General Provider Information

NPI Number	:	1700327905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISE HYSER DO

Provider Business Mailing Address
First Line	:	901 MCCLINTOCK DR STE 202
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-0872
Country	:	US
Telephone Number	:	630-655-6770
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 W ADDISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4635
Country	:	US
Telephone Number	:	888-220-6432
Fax Number	:

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

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	10/13/2025

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