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General NPI Number Information
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NPI Number | 1760805840
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Entity Type | Individual
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Provider Name | ELIZABETH ANNE SHICK DC
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 102 MAPLE AVE
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City | ROCHELLE
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State | IL
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Zip | 61068
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Country | US
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Telephone | 815-562-5333
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Fax | 815-562-5833
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Provider Business Mailing Address
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Address Line | 102 MAPLE AVE
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City | ROCHELLE
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State | IL
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Zip | 61068-8926
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Country | US
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Telephone | 815-562-5333
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Fax | 815-562-5833
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.012574
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License Number State | IL
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