Provider Demographics
NPI:1164841722
Name:NIE, DAISY (MD)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:NIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 RENAISSANCE DR STE 320
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1471
Mailing Address - Country:US
Mailing Address - Phone:312-298-9780
Mailing Address - Fax:224-985-2119
Practice Address - Street 1:333 N MICHIGAN AVE STE 1120
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4001
Practice Address - Country:US
Practice Address - Phone:847-759-9110
Practice Address - Fax:224-985-2119
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1468372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry