Individual
DR. ELIZABETH E OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20613 N BROAD ST, CARLINVILLE, IL 62626-3717
(217) 854-5099
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036121379
IL
207R00000X
Internal Medicine Physician
41416-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121379
—
IL
01
—
R02893
MEDICARE PTAN
IL
Enumeration date
04/22/2006
Last updated
05/21/2020
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