Provider Demographics
NPI:1902792252
Name:SHULDINER, ELIZABETH ABIGAIL ROSE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ABIGAIL ROSE
Last Name:SHULDINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 W MADISON ST APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2000
Mailing Address - Country:US
Mailing Address - Phone:312-420-4181
Mailing Address - Fax:
Practice Address - Street 1:1161 W MADISON ST APT 3N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2000
Practice Address - Country:US
Practice Address - Phone:312-420-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program