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NPI Code Detail

MEDICARE: ELIZABETH R NYE M.D. ,S.C.

MEDICARE: ELIZABETH R NYE M.D. ,S.C.
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
1207V00000XObstetrics & Gynecology Physician036074722IL
2207V00000XObstetrics & Gynecology Physician036085007IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131603891OTHERILBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821211129
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZABETH R NYE M.D. ,S.C.
Provider Business Mailing Address
First Line : 345 ASHLAND AVE
Second Line :
City : RIVER FOREST
State : IL
Zip : 60305-2109
Country : US
Telephone Number : 312-670-2530
Fax Number : 312-670-8035
Provider Business Practice Location Address
First Line : 345 ASHLAND AVE
Second Line :
City : RIVER FOREST
State : IL
Zip : 60305-2109
Country : US
Telephone Number : 312-670-2530
Fax Number : 312-670-8035
Authorized Official
Title or Position : FINANCIAL MANAGER
Name : MRS. CINDY S HUMMONS
Credential :
Telephone Number : 312-670-2530
Provider Enumeration Date : 04/11/2007
Last Update Date : 02/16/2024

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