institution
Elisabeth I. Wallner, M.d., S.c.
Primary Care Clinic/Center in Chicago, Illinois
NPI 1396915955

Elisabeth I. Wallner, M.d., S.c. is a Primary Care Clinic/Center based in Chicago, IL and is specialized in Primary Care. Elisabeth I. Wallner, M.d., S.c. practices in Chicago, IL. The NPI Number for Elisabeth I. Wallner, M.d., S.c. is 1396915955 and holds a License No. 36089720 (Illinois).

The current practice location address for Elisabeth I. Wallner, M.d., S.c. is 676 N St Clair, Chicago, IL and can be reached out via phone at 312-926-0888 and via fax at 312-926-0889.

Location: 676 N St Clair, Chicago, IL, 60611-0075
institution
Provider Profile Details
NPI Number
1396915955
Provider Name
Elisabeth I. Wallner, M.d., S.c.
Credential
Provider Entity Type
Organization
Address
676 N St Clair, Chicago, IL, 60611-0075
Phone Number
312-926-0888
Fax Number
312-926-0889
Provider Enumeration Date
03/10/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001627372 01 IL BLUE CROSS BLUE SHIELD
9750416 01 IL CIGNA
036089720 05 IL
institution
Provider Business Practice Location Address Details
Address
676 N St Clair
City
State
Zip
60611
Phone Number
312-926-0888
Fax Number
312-926-0889
person
Provider Business Mailing Address Details
Address
676 N St Clair
City
State
Zip
60611
Phone Number
312-926-0888
Fax Number
312-926-0889
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
36089720 (Illinois)
Definition
Definition to come...
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