Provider Demographics
NPI:1952984593
Name:TOUSSAINT, NADLIE BETHINA (MD)
Entity Type:Individual
Prefix:DR
First Name:NADLIE
Middle Name:BETHINA
Last Name:TOUSSAINT
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 1:1515 W MONROE ST UNIT 30M
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1562
Mailing Address - Country:US
Mailing Address - Phone:312-355-3733
Mailing Address - Fax:
Practice Address - Street 1:1515 W MONROE ST UNIT 30M
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1562
Practice Address - Country:US
Practice Address - Phone:312-355-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL125.083052208600000X
IL036.168179208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice