Provider Demographics
NPI:1710200803
Name:ADAM, ELIZABETH (DN)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:ADAM
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 908 E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2252
Mailing Address - Country:US
Mailing Address - Phone:773-744-6867
Mailing Address - Fax:
Practice Address - Street 1:845 N MICHIGAN AVE
Practice Address - Street 2:SUITE 908 E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2252
Practice Address - Country:US
Practice Address - Phone:773-744-6867
Practice Address - Fax:773-763-6874
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181.000361172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath