Lindsay Travelstead Fazio, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007853 Issued in IL

Practice address

2050 Pfingsten Rd Ste 200
Glenview, IL 60026

Phone

(847) 657-1820

Fax

(847) 657-1825

NPI assigned

Apr 17, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1306010616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 HARTREY AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021056",
            "telephone_number": "847-657-1820",
            "fax_number": "847-657-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 PFINGSTEN RD STE 200",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-657-1820",
            "fax_number": "847-657-1825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Pfingsten Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "60026",
            "country_code": "US",
            "telephone_number": "847-657-1820",
            "fax_number": "847-657-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 Pfingsten Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "60026",
            "country_code": "US",
            "telephone_number": "847-657-1820",
            "fax_number": "847-657-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "LINDSAY",
        "middle_name": "TRAVELSTEAD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Glenview, IL
• Providers in Glenview, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.