Provider Demographics
NPI:1437304888
Name:YOUSSEF, NANCY HANY (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:HANY
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9830 RIDGELAND AVE STE 9A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-2668
Mailing Address - Country:US
Mailing Address - Phone:781-338-0507
Mailing Address - Fax:
Practice Address - Street 1:9830 RIDGELAND AVE STE 9A
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2668
Practice Address - Country:US
Practice Address - Phone:708-581-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-27
Last Update Date:2021-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCDR.0000040207Q00000X
NE30448207Q00000X
UT10574430-1205207Q00000X
WI35-320207Q00000X
WV27977207Q00000X
NV17511207Q00000X
KS04-40495207Q00000X
MS25371207Q00000X
IAMD-44697207Q00000X
IL036.127111207Q00000X
WY11282C207Q00000X
AZ55354207Q00000X
TXR8295207Q00000X
MN63030207Q00000X
MA248317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110090106AMedicaid
MA110090106AMedicaid