Healthcare Provider Details

I. General information

NPI: 1750467858
Provider Name (Legal Business Name): ELIZABETH SAXTON-WILLIAMS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 N LINCOLN AVE
CHICAGO IL
60618-3131
US

IV. Provider business mailing address

1926 W IRVING PARK ROAD
CHICAGO IL
60613
US

V. Phone/Fax

Practice location:
  • Phone: 773-360-8671
  • Fax:
Mailing address:
  • Phone: 773-525-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046009866
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: