Individual
ELIZABETH A SCHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, FCCP
Contact information
Practice address
4 EXECUTIVE CT, SUITE 3, SOUTH BARRINGTON, IL 60010
(815) 477-7350
(815) 477-7351
Mailing address
360 STATION DRIVE, SUITE 230, CRYSTAL LAKE, IL 60014
(815) 477-7350
(815) 477-7351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036078246
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078246
—
IL
01
—
127402
HEALTH ALLIANCE
IL
01
—
304906
GHP
IL
01
—
3932056
BCBS
IL
01
—
7210895
AETNA
IL
01
—
770669
HEALTHLINK
IL
Enumeration date
05/23/2006
Last updated
04/25/2012
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