Provider Demographics
NPI:1588370514
Name:LIZER, CHELSEY E (NP)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:E
Last Name:LIZER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26-17 WESTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LANARK
Mailing Address - State:IL
Mailing Address - Zip Code:61046-9205
Mailing Address - Country:US
Mailing Address - Phone:815-238-1631
Mailing Address - Fax:
Practice Address - Street 1:1045 W STEPHENSON ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-4864
Practice Address - Country:US
Practice Address - Phone:815-599-6000
Practice Address - Fax:815-599-7679
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026731363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner