Healthcare Provider Details

I. General information

NPI: 1497426290
Provider Name (Legal Business Name): ELIZABETH ANNE STEFFENS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANNE SMITH

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 S DIVISION ST
HARVARD IL
60033-3247
US

IV. Provider business mailing address

29624 NETWORK PL
CHICAGO IL
60673-1296
US

V. Phone/Fax

Practice location:
  • Phone: 815-943-1122
  • Fax: 815-943-4260
Mailing address:
  • Phone: 608-756-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209023091
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209023091
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: