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NPI Code Detail

MEDICARE: ELIZABETH STANTON

MEDICARE: ELIZABETH STANTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant085.003324IL

General Provider Information

NPI Number : 1275772766
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH STANTON
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3068
Country : US
Telephone Number : 312-695-8182
Fax Number : 312-695-4303
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3068
Country : US
Telephone Number : 312-695-8182
Fax Number : 312-695-4303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2009
Last Update Date : 04/06/2026

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Directions to “ ELIZABETH STANTON ” Practice Location

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