Provider Demographics
NPI:1780681700
Name:FRANCZYK, ELIZABETH (MD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:FRANCZYK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 M L KING DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CENTRALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62801-3060
Mailing Address - Country:US
Mailing Address - Phone:618-532-6222
Mailing Address - Fax:618-532-6246
Practice Address - Street 1:1050 M L KING DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CENTRALIA
Practice Address - State:IL
Practice Address - Zip Code:62801-3060
Practice Address - Country:US
Practice Address - Phone:618-532-6222
Practice Address - Fax:618-532-6246
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070422174400000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0006100115OtherBLUE CROSS/BLUE SHILED
IL036070422Medicaid
IL206570Medicare ID - Type Unspecified