Individual
DR. ELIZABETH A PICKVANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2350 N ROCKTON AVE, ROCKFORD, IL 61103-3600
(815) 971-7400
Mailing address
2400 N ROCKTON AVE, ROCKFORD, IL 61103-3655
(815) 971-7400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
14838R
LA
207X00000X
Orthopaedic Surgery Physician
24215
OK
207X00000X
Orthopaedic Surgery Physician
MD.14838R
LA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
036141771
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1148703
—
LA
05
—
200189090A
—
OK
Enumeration date
01/25/2006
Last updated
07/21/2022
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