ELLEN GAYNOR MD NPI 1225015589

NPI Information

NPI: 1225015589
Provider Name: ELLEN GAYNOR, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Address:
2160 S FIRST AVE
LUH - NORTH ENT., RM. 7604
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-3304
Get Directions

Ellen Gaynor, MD is a hematology and oncology internal medicine in Maywood, IL. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Ellen Gaynor, MD NPI is 1225015589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2160 S FIRST AVE
LUH - NORTH ENT., RM. 7604
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-3304
Fax: (708) 216-1259

The enumeration date for this NPI number is 12/28/2005 and was last updated on 9/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RH0003X	Internal Medicine	Hematology & Oncology	36060577	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	D93974	MEDICARE UPIN
2	36060577	MEDICAID	ILLINOIS
3	737431	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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