Healthcare Provider Details

I. General information

NPI: 1487507018
Provider Name (Legal Business Name): ELIZABETH ELAM BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 1ST ST N BLDG 3100B
VIRGINIA MN
55792-2457
US

IV. Provider business mailing address

225 1ST ST N BLDG 3100B
VIRGINIA MN
55792-2457
US

V. Phone/Fax

Practice location:
  • Phone: 630-388-9114
  • Fax:
Mailing address:
  • Phone: 218-481-7660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32159
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: