MEDICARE: NORYBDEER LIMITED

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		IL

General Provider Information

NPI Number	:	1851328546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORYBDEER LIMITED

Provider Business Mailing Address
First Line	:	519 S 7TH AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-1506
Country	:	US
Telephone Number	:	708-345-9894
Fax Number	:	708-345-9894

Provider Business Practice Location Address
First Line	:	45 W 111TH ST
Second Line	:	SUITE B
City	:	CHICAGO
State	:	IL
Zip	:	60628-4247
Country	:	US
Telephone Number	:	773-370-5254
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHIRLEY WALKER
Credential	:
Telephone Number	:	708-345-9894

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	10/25/2007

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Directions to “NORYBDEER LIMITED ” Practice Location

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