Provider Demographics
NPI:1215076153
Name:ZIMMERMANN, ELIZABETH (BETH) T (APN)
Entity type:Individual
Prefix:
First Name:ELIZABETH (BETH)
Middle Name:T
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:PAULINE
Other - Last Name:ZIMMERMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:360 E RANDOLPH ST
Mailing Address - Street 2:APT. #407
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5069
Mailing Address - Country:US
Mailing Address - Phone:312-519-1739
Mailing Address - Fax:
Practice Address - Street 1:5839 SO. MARYLAND AVE.
Practice Address - Street 2:MC4062-UCCH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-702-6175
Practice Address - Fax:773-702-1192
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine