Provider Demographics
NPI:1821211129
Name:ELIZABETH R NYE M.D. ,S.C.
Entity Type:Organization
Organization Name:ELIZABETH R NYE M.D. ,S.C.
Other - Org Name:NYE PARTNERS IN WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-670-2530
Mailing Address - Street 1:345 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-2109
Mailing Address - Country:US
Mailing Address - Phone:312-670-2530
Mailing Address - Fax:312-670-8035
Practice Address - Street 1:345 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-2109
Practice Address - Country:US
Practice Address - Phone:312-670-2530
Practice Address - Fax:312-670-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074722207V00000X
IL036085007207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31603891OtherBLUE CROSS BLUE SHIELD
IL036085007Medicaid
ILK06440Medicare PIN
ILE18778Medicare UPIN
ILF36841Medicare UPIN
ILK06438Medicare PIN
IL208968Medicare PIN