Organization
NANCY J LITZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA BOMBARD (BILLING MANAGER)
(630) 897-6851
Entity
Organization
Contact information
Practice address
45 S PARK BLVD STE 355, GLEN ELLYN, IL 60137-6283
(630) 469-6697
Mailing address
45 S PARK BLVD STE 355, GLEN ELLYN, IL 60137-6283
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232634
BCBS
IL
01
—
DG7517
RAIL ROAD MEDICARE
IL
Enumeration date
01/21/2008
Last updated
04/01/2008
Update your record
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