Individual
ELIZABETH SIERRA BOTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
5764 S ARCHER AVE, CHICAGO, IL 60638-1643
(773) 284-0888
(773) 284-0880
Mailing address
5764 S ARCHER AVE, CHICAGO, IL 60638-1643
(773) 284-0888
(773) 284-0880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017163
IL
225100000X
Physical Therapist
10760-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633794
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/07/2007
Last updated
07/07/2010
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