Individual
ELIZABETH CLOUGHLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(888) 824-0200
Mailing address
3201 HICKORY ST, PORTAGE, IN 46368-4165
(708) 677-2804
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041430958
IL
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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