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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
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