Provider Demographics
NPI:1699001107
Name:OPPERT, ELIZABETH ANNA (CNM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:OPPERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:STE LL7
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3543
Mailing Address - Country:US
Mailing Address - Phone:773-878-8200
Mailing Address - Fax:773-293-4197
Practice Address - Street 1:5140 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 645
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3645
Practice Address - Country:US
Practice Address - Phone:773-989-6200
Practice Address - Fax:773-989-6201
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2024-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209007739367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife