Provider Demographics
NPI:1831495845
Name:KRAUS, ELIZABETH RAYE (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RAYE
Last Name:KRAUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:IL
Mailing Address - Zip Code:62286-1048
Mailing Address - Country:US
Mailing Address - Phone:618-443-6228
Mailing Address - Fax:618-443-2956
Practice Address - Street 1:1300 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:IL
Practice Address - Zip Code:62286-1048
Practice Address - Country:US
Practice Address - Phone:618-443-6228
Practice Address - Fax:618-443-2956
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008651363LA2200X
IL209.008651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health