Provider Demographics
NPI:1629154679
Name:MCILREE, ELIZABETH GALE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GALE
Last Name:MCILREE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 WEST CENTER ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2388
Mailing Address - Country:US
Mailing Address - Phone:402-397-6600
Mailing Address - Fax:402-397-8318
Practice Address - Street 1:7205 WEST CENTER ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2388
Practice Address - Country:US
Practice Address - Phone:402-397-6600
Practice Address - Fax:402-397-8318
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110320207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47072606813Medicaid