Individual
ELIZABETH MENDELOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 FAIRWAY DR, FREEPORT, IL 61032-6600
(815) 599-7950
Mailing address
PO BOX 268, FREEPORT, IL 61032-0268
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006109
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041219602
REGISTERED NURSE LICENSE
IL
Enumeration date
08/04/2006
Last updated
09/07/2021
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