Basic Information
Provider Information
NPI: 1376034439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELL
FirstName: ELIZABETH
MiddleName: FRANCES
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 180 HARVESTER DR STE 110
Address2:  
City: BURR RIDGE
State: IL
PostalCode: 605276686
CountryCode: US
TelephoneNumber: 7737021150
FaxNumber:  
Practice Location
Address1: 5841 S MARYLAND AVE # MC5065
Address2:  
City: CHICAGO
State: IL
PostalCode: 606371443
CountryCode: US
TelephoneNumber: 7738349740
FaxNumber: 7737531095
Other Information
ProviderEnumerationDate: 05/24/2018
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125072215ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200X036155644ILY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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