Nietert, Elizabeth

Nietert, Elizabeth is an individual health care provider with primary practice located at 751 N Rutledge St Suite 2300, Springfield IL 62702-4968. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Nietert, Elizabeth can be contacted via phone (217) 545-3821.

Contact Information

Primary practice address
751 N Rutledge St Suite 2300 Springfield IL 62702-4968
Phone: (217) 545-3821
Fax: (217) 545-4485
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 54439-020 Wisconsin
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036-130434 Illinois

Profile Details

NPI number 1619199072
LBN Legal business name Nietert, Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619199072 NPPES
Illinois MEDICAID 036130434
Illinois MEDICAID 1619199072
Illinois Other 171400024
Illinois Other 54439-020

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