Provider Demographics
NPI:1154392645
Name:WOO-STRAUSS, ELIZABETH KING (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KING
Last Name:WOO-STRAUSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 RIDGE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2455
Mailing Address - Country:US
Mailing Address - Phone:847-869-1192
Mailing Address - Fax:847-869-8354
Practice Address - Street 1:2500 RIDGE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2455
Practice Address - Country:US
Practice Address - Phone:847-869-1192
Practice Address - Fax:847-869-8354
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-094253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
481120Medicare ID - Type Unspecified
G59393Medicare UPIN