Healthcare Provider Details

I. General information

NPI: 1992354195
Provider Name (Legal Business Name): LIZ FRANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZ FRANCO APRN

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 N HALSTED ST
CHICAGO IL
60657-3419
US

IV. Provider business mailing address

3245 N HALSTED ST
CHICAGO IL
60657-3419
US

V. Phone/Fax

Practice location:
  • Phone: 773-388-1600
  • Fax:
Mailing address:
  • Phone: 773-388-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209019974
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: