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NPI Code Detail

MEDICARE: DR. ELIZABETH ANNE CALLAHAN DO

MEDICARE: DR. ELIZABETH ANNE CALLAHAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician036170756IL
2208100000XPhysical Medicine & Rehabilitation Physician036170756IL

General Provider Information

NPI Number : 1417585704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH ANNE CALLAHAN DO
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-250-2040
Fax Number : 837-570-5315
Provider Business Practice Location Address
First Line : 120 SPALDING DR STE 308
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-6521
Country : US
Telephone Number : 630-527-7730
Fax Number : 331-221-2776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2020
Last Update Date : 08/25/2025

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