Individual
ELIZABETH L LOCKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036157258
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036157258
STATE LICENSE
IL
01
—
336116478
CS LICENSE
IL
01
—
425496
SPECIALTY BOARDS
IL
Enumeration date
03/26/2018
Last updated
03/07/2023
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