ELIZABETH MAUREEN WICKSTROM (NPI# 1548873813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548873813 |
| Entity Type | Individual |
| Full Name | ELIZABETH MAUREEN WICKSTROM |
| Practice Address |
2013 Jackson Ave Apt 1 Evanston IL 60201-6603 |
| Practice Telephone | 7085181837 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952473118 | Elizabeth Ann Wickstrom | Obstetrics & Gynecology | 4401 Wornall Rd, Kansas City, MO 64111-3220 | 2006-11-14 |
| Street Address |
2013 JACKSON AVE APT 1 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201-6603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| Find all providers in zip 60201 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861032385 | Amy J Graham | Counselor | 622 Davis St Ste 200, Evanston, IL 60201-4491 | 2020-01-13 |
| 1700431491 | Ume Abi Saleem | Counselor | 2100 Ridge Ave # G320, Evanston, IL 60201-2716 | 2019-08-08 |
| 1598324766 | Lauren Claire Bajek | Counselor | 636 Church St Ste 301, Evanston, IL 60201-6030 | 2019-06-11 |
| 1831655737 | Shalini Lulla LLC | Counselor | 1830 Sherman Ave Ste 307, Evanston, IL 60201-3773 | 2019-02-15 |
| 1619440831 | Amar Vijay Dave | Counselor | 1509 Ridge Ave, Evanston, IL 60201-4135 | 2019-01-10 |
| 1558848242 | Joanne Barbara Lagattolla | Counselor | 990 Grove St # 303, Evanston, IL 60201-6510 | 2018-07-25 |
| 1205326303 | Insideout Living Inc II | Counselor | 1618 Orrington Ave Ste 311, Evanston, IL 60201-5016 | 2018-05-14 |
| 1881181121 | Liliana Cardona | Counselor | 2005 Emerson St, Evanston, IL 60201-3305 | 2018-04-20 |
| 1316466568 | Angela Mclean | Counselor | 2645 Asbury Ave, Evanston, IL 60201-1605 | 2017-09-19 |
| 1104348101 | Lizabeth Burgess | Counselor | 355 Ridge Ave Fl 2, Evanston, IL 60202-3328 | 2017-07-11 |
| Find all providers in EVANSTON | ||||
Please comment or provide details below to improve the information on ELIZABETH MAUREEN WICKSTROM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.