Elizabeth M Van Doorn, PA-C
Physician Assistant in Chicago, IL. Individual provider (NPI-1).
NPI number1164046199
StatusActive
Last updated in NPPESOct 5, 2022
Details
- NPI
- 1164046199
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth M Van Doorn
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2020
- Certification date
- Oct 5, 2022
- Last updated
- Oct 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085009021 | IL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
675 N Saint Clair St Ste 19-100Chicago, IL 60611-5969
Phone 312-664-3278 · Fax 312-695-5774
Mailing address
675 N Saint Clair St Ste 19-100Chicago, IL 60611-5969
Phone 312-664-3278 · Fax 312-695-5774
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