Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036-093110 | IL |
Y | 208600000X | Surgeon | 036-093110 | IL |
N | 2086X0206X | Surgical Oncologist | 036-093110 | IL |
NPI | 1457464638 |
---|---|
Provider Name | Dr. Elizabeth Ann Marcus |
First Address | Chicago, IL 60614-3302 |
Second Address | Chicago, IL 60612-3771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 27/04/2021 |