Organization
DR ELIZABETH FAZIO & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH FAZIO PSY.D. (OWNER)
(708) 899-8150
Entity
Organization
Contact information
Practice address
4160 ROUTE 83, SUITE 307, LONG GROVE, IL 60047
(708) 899-8150
Mailing address
PO BOX 613, CHANNAHON, IL 60410-0613
(815) 521-1889
(815) 521-1889
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007381
IL
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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