Provider Demographics
NPI:1134433873
Name:ESCARRIA, ELIZABETH (DMD)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:ESCARRIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 COLONY LANE
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATE
Mailing Address - State:IL
Mailing Address - Zip Code:60192
Mailing Address - Country:US
Mailing Address - Phone:857-383-0822
Mailing Address - Fax:847-488-9147
Practice Address - Street 1:1185 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120
Practice Address - Country:US
Practice Address - Phone:847-488-9145
Practice Address - Fax:847-488-9147
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1855530122300000X
FL19184122300000X
IL019028852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist