Individual
ELIZABETH PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-2000
Mailing address
10127 WESTMANOR DR, FRANKLIN PARK, IL 60131-3130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209021646
IL
Other
Enumeration date
02/23/2014
Last updated
09/02/2020
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