Healthcare Provider Details

I. General information

NPI: 1811836117
Provider Name (Legal Business Name): ELIZABETH ANN CHADWICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 S 20TH ST
MILWAUKEE WI
53215-4940
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-645-1808
  • Fax: 414-645-1170
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6389-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: