Individual
MISS ELIZABETH BLAIR BALLANTYNE HORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
225 E CHICAGO AVE # 30, CHICAGO, IL 60611-2991
(312) 227-4853
Mailing address
225 E CHICAGO AVE # 30, CHICAGO, IL 60611-2991
(312) 227-4853
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
704160
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
209.015914
IL
Other
Enumeration date
07/18/2016
Last updated
12/28/2021
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