Individual
DR. ELIZABETH KILNER WICKWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
25 E. WASHINGTON STREET, SUITE 606, CHICAGO, IL 60602
(312) 444-1111
(312) 444-1953
Mailing address
25 E. WASHINGTON STREET, SUITE 606, CHICAGO, IL 60602
(312) 444-1111
(312) 444-1953
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011209
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0935B
BCBS
—
Enumeration date
07/09/2010
Last updated
07/02/2019
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