Healthcare Provider Details

I. General information

NPI: 1871421057
Provider Name (Legal Business Name): ELIZABETH SOMONE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6646 N LORON AVE
CHICAGO IL
60646-2710
US

IV. Provider business mailing address

6646 N. LORON AVENUE
CHICAGO IL
60646
US

V. Phone/Fax

Practice location:
  • Phone: 708-207-4782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041444546
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: