Maryke Nijhuis Neiberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010954 Issued in IL

Practice address

3450 Lacey Rd
Suite 272
Downers Grove, IL 60515-5430

Phone

(630) 743-4967

Fax

(630) 743-4537

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwestern University

  • Clinic/Center
  • Downers Grove, IL
  • NPI 1538445317
  NPD (past)
• Leominster Family Eyecare PLLC

  • Optometrist
  • Leominster, MA
  • NPI 1891342457
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1649344482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "address_2": "SUITE 272",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4967",
            "fax_number": "630-743-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "address_2": "SUITE 272",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4967",
            "fax_number": "630-743-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIBERG",
        "first_name": "MARYKE",
        "middle_name": "NIJHUIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010954",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Nicole Nash, DMD
• Nisha Nayak, NP
• Emily Nayes, M.A., CCC-SLP
• Geoffrey Needleman
• Mae Alyssa Loudette Negado, RPH
• Corina Nelson, LPC
• La Vera Nelson, APRN
• Lauren Elizabeth Nelson, D.C.
• Lori J Nelson, SLP
• Paul Daniel Nelson, DPM

• Optometrist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.