Healthcare Provider Details

I. General information

NPI: 1194806711
Provider Name (Legal Business Name): ELIZABETH TORRES APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE SUITE 1410
CHICAGO IL
60602-3402
US

IV. Provider business mailing address

30 N MICHIGAN AVE SUITE 1410
CHICAGO IL
60602-3402
US

V. Phone/Fax

Practice location:
  • Phone: 312-726-7272
  • Fax: 312-899-8382
Mailing address:
  • Phone: 312-726-7272
  • Fax: 312-899-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number209006229
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: