Individual
MISS ELIZABETH OMOTAYO ABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3714 N PROSPECT RD, PEORIA, IL 61614-7743
(309) 550-7888
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
070022228
IL
225100000X
Physical Therapist
Primary
070-022228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021
—
IL
Enumeration date
12/20/2016
Last updated
02/06/2020
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