Provider Demographics
NPI:1992242051
Name:RITTENBACHER, ELIZABETH LOUISE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:RITTENBACHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 N 12,000 W RD
Mailing Address - Street 2:
Mailing Address - City:BONFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60913-7383
Mailing Address - Country:US
Mailing Address - Phone:815-426-6299
Mailing Address - Fax:
Practice Address - Street 1:1617 W. JEFFERSON ST
Practice Address - Street 2:DEPT OF REHAB ST. 450
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:800-804-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043081530164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse