Elizabeth Katherine Stoltz

Individual provider Active NPI Diagnostic Ultrasound Physician · Fulton, IL

NPI 1609498245 · NPPES record last updated May 16, 2020

Key facts

NPI
1609498245
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Ultrasound Physician 2085U0001X
License
157736 (IL)
Practice address
1126 14TH Ave
Fulton, IL 61252-1139
Phone
(563) 212-9983
NPI assigned
May 16, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
157736ILMDDiagnostic Ultrasound Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 157736 IL Yes

Addresses

Primary practice location

1126 14TH Ave
Fulton, IL 61252-1139

Mailing address

1126 14TH Ave
Fulton, IL 61252-1139

Other providers in Fulton, IL

All providers in Fulton, IL · Diagnostic Ultrasound Physician in Illinois

Sources for this page

Verify at the official NPI Registry.