Individual
MS. ELIZABETH WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6565 N AVONDALE AVE, CHICAGO, IL 60631-1782
(773) 250-1234
Mailing address
6565 N AVONDALE AVE, CHICAGO, IL 60631-1782
(773) 250-1234
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.016596
IL
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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