Individual
DR. ELIZABETH ANNA WANTUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3300
Mailing address
165 N CANAL ST, #1319, CHICAGO, IL 60606-1549
(312) 775-0073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125053422
IL
208M00000X
Hospitalist Physician
Primary
036125197
IL
Other
Enumeration date
06/17/2008
Last updated
12/10/2021
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