Provider Demographics
NPI:1265470884
Name:WILLIAMSON, ELIZABETH JUNE (D,P,T)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JUNE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:D,P,T
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3550 N LAKE SHORE DR
Mailing Address - Street 2:UNIT 711
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1944
Mailing Address - Country:US
Mailing Address - Phone:815-519-6582
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 3500
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-934-7062
Practice Address - Fax:708-934-7065
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070.015086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist