Healthcare Provider Details

I. General information

NPI: 1942438742
Provider Name (Legal Business Name): ELIZABETH SATTERLY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 W CONGRESS PKWY
CHICAGO IL
60612-3833
US

IV. Provider business mailing address

2132 W POTOMAC AVE APT. #1
CHICAGO IL
60622-3010
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125.057192
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: