Individual
MRS. LILIANA M ERAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 PENNY AVE, SUITE 100, EAST DUNDEE, IL 60118-1431
(847) 428-0915
(847) 551-9509
Mailing address
PO BOX 1509, ELGIN, IL 60121-1509
(224) 238-4160
(847) 783-0599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.118714
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118714
—
IL
01
—
04532482
BLUE CROSS BLUE SHIELD
IL
01
—
05300348
IL HEALTH CONNECT
IL
Enumeration date
05/02/2007
Last updated
09/05/2012
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