MEDICARE: MADELINE VANDERHEID-NYE

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	235Z00000X	Speech-Language Pathologist	242.008434	IL

General Provider Information

NPI Number	:	1962393660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE VANDERHEID-NYE

Provider Business Mailing Address
First Line	:	1650 W ADAMS ST APT 408
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3649 N MARSHFIELD AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6959
Country	:	US
Telephone Number	:	925-366-3809
Fax Number	:

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

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	07/10/2025

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Directions to “ MADELINE VANDERHEID-NYE ” Practice Location

Language	Start Address	Practice Location

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