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General NPI Number Information
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NPI Number | 1366818221
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Entity Type | Organization
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Legal Business Name | ELIZABETH M GEORGES, MD, LLC
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST SUITE 1010
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City | CHICAGO
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State | IL
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Zip | 60602-1708
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Country | US
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Telephone | 312-725-9635
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Fax | 844-715-9465
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Provider Business Mailing Address
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Address Line | 25 E WASHINGTON ST SUITE 1010
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City | CHICAGO
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State | IL
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Zip | 60602-1708
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Country | US
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Telephone | 312-725-9635
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Fax | 844-715-9465
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Authorized Official
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Title or Position | MANAGER
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Name | ELIZABETH M GEORGES
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Credential | M.D.
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Telephone | 312-725-9635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 248.001219
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License Number State | IL
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