Elizabeth Fyfe, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146012503 Issued in IL

Practice address

3340 Dundee Rd Ste 2N3
Northbrook, IL 60062-2332

Phone

(847) 380-8992

NPI assigned

Jan 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mobile Endoscopix LLC

  • Speech-Language Pathologist
  • Northbrook, IL
  • NPI 1548642838
  NPD (past)

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1396167367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 DUNDEE RD STE 2N3",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 DUNDEE RD STE 2N3",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622332",
            "telephone_number": "847-380-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYFE",
        "first_name": "ELIZABETH",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3888-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146012503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Life Rejuvenation
• Lauren Fulton, LCSW
• Functional Medical Wellness Center , LLC
• Anna Katerina Funk
• Joan Eileen Funk, PSY.D.
• Gaf/Lake Cook Terrace
• Joel Galiotto
• Tammy Louise Galizia, DPM
• Marie Ann Calayag Gallano
• Kayla Galvan

• Speech-Language Pathologist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.