Provider Demographics
NPI:1346449527
Name:NODINE, ELIZABETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:NODINE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3010 GRAND AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2321
Mailing Address - Country:US
Mailing Address - Phone:847-377-8440
Mailing Address - Fax:847-377-8808
Practice Address - Street 1:2215 14TH ST
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-1618
Practice Address - Country:US
Practice Address - Phone:847-984-5200
Practice Address - Fax:847-984-5642
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2011-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036098441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine