DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ELIZABETH NICOLE MANCUSO, MB BCH BAO

Deactivated

ELIZABETH NICOLE MANCUSO, MB BCH BAO is a Pediatric Critical Care Medicine healthcare provider located in CHICAGO, Illinois. NPI 1265056659 is deactivated in the NPPES registry. Verify at CMS.

Pediatric Critical Care Medicine · CHICAGO, IL

This NPI has been deactivated. The record was deactivated on January 18, 2022. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1265056659
Provider Type
Individual
Gender
Female
NPI Issued
Jun 2, 2020 (1.6301369863014 yrs)
Last Updated
Jun 29, 2023
Deactivated
Jan 18, 2022
License
036.165352 (IL)

Practice Information

Address
5841 S MARYLAND AVE # MC1145
CHICAGO, IL, 606371443
Browse IL providers · Browse ZIP 60637
Phone
7737023020
Primary Specialty
Pediatric Critical Care Medicine
2080P0203X

Other Pediatric Critical Care Medicine Providers in CHICAGO, IL

Name Credential NPI
DR. MOHAMMAD I AKHTAR M.D. 1942294897
DR. STEVEN O LESTRUD MD 1285619726
ZEHAVA LELA NOAH MD 1942269634
DR. KELLY NICOLE MICHELSON MD MPH 1306806278
DEREK S WHEELER M.D. 1912959610
RACHEL WOLFSON 1407897887
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.