# ELISABETH AV DESAPEREIRA,MD,LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578648408
- **Authorized official:** ELISABETH A V DESAPEREIRA M.D. (PRESIDENT)
- **Authorized official phone:** (847) 389-5930

## Contact information

- **Practice address:** 1117 S MILWAUKEE AVE, SUITE B8, LIBERTYVILLE, IL 60048-3798
- **Practice address phone:** (847) 281-9990
- **Practice address fax:** (847) 295-0293
- **Mailing address:** 3018 PARKSIDE DR, HIGHLAND PARK, IL 60035-1067
- **Mailing address phone:** (847) 433-0057
- **Mailing address fax:** (847) 432-2174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/08/2008