Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036074722 | IL |
N | 207VG0400X | Gynecologist | 036074722 | IL |
N | 207VX0000X | Obstetrician | 036074722 | IL |
NPI | 1356356166 |
---|---|
Provider Name | Elizabeth Robin Nye |
First Address | River Forest, IL 60305-2109 |
Second Address | River Forest, IL 60305-2109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 28/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036074722 | (05) | IL |
1356356166 | INDIVIDUAL NPI (01) | IL |
1821211129 | GROUP NPI (01) | IL |
31603891 | BC/BS PROVIDER NUMBER (01) | IL |
E18778 | (02) | IL |