Individual
ELIZABETH WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1600 W MORTON AVE, JACKSONVILLE, IL 62650-2718
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(175) 287-5412
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.012500
IL
363LF0000X
Family Nurse Practitioner
Primary
209012500
IL
Other
Enumeration date
02/19/2015
Last updated
04/22/2026
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