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Individual

ELIZABETH LOUISE FISK WALSH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.A., L.C.P.C.

Contact information

Practice address
30 N MICHIGAN AVE, SUITE 1516, CHICAGO, IL 60602-3402
(312) 514-5689
(312) 943-8721
Mailing address
30 N MICHIGAN AVE, SUITE 1516, CHICAGO, IL 60602-3402
(312) 514-5689
(312) 943-8721

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01635454
BCBS PROVIDER NUMBER
IL
01
361350
MANAGED HEALTHCARE PIN
IL
01
7393766
AETNA PIN
IL
Enumeration date
02/17/2006
Last updated
07/08/2007
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