Individual
MRS. ELIZABETH D. DECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
400 RIVERSIDE DR STE 2100, BOURBONNAIS, IL 60914-5004
(815) 935-2784
(815) 935-5687
Mailing address
400 RIVERSIDE DR STE 2100, BOURBONNAIS, IL 60914-5004
(815) 935-2784
(815) 935-5687
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209005074
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4632073
BLUE CROSS
IL
01
—
DD8385
RAILROAD MEDICARE
IL
Enumeration date
01/23/2006
Last updated
10/21/2019
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