Individual
ERICA L ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3351 W MAIN ST, ST CHARLES, IL 60175-1004
(800) 323-8622
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.009585
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.009585
STATE LICENSE
IL
01
—
309.005869
STATE CDS
IL
Enumeration date
06/20/2012
Last updated
10/05/2022
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