Provider Demographics
NPI:1568783991
Name:LOWDEN, ELIZABETH A (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:LOWDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:KOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 S WACKER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-4421
Mailing Address - Country:US
Mailing Address - Phone:617-505-1520
Mailing Address - Fax:
Practice Address - Street 1:125 S WACKER DR STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-4421
Practice Address - Country:US
Practice Address - Phone:617-505-1520
Practice Address - Fax:617-928-8401
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132428207QB0002X, 207R00000X, 207RB0002X, 207RE0101X
IL125-057764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE GROUP PTAN
ILF400308155OtherMEDICARE INDIVIDUAL PTAN
IL036132428Medicaid