Active NPI
Dr Elizabeth Fazio & Associates, LLC
- Clinical Psychologist
- Long Grove, IL
National Provider Identifier
1508306895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071007381
- Legal business name
- DR ELIZABETH FAZIO & ASSOCIATES, LLC
- Practice address
- 4160 Route 83
Suite 307
Long Grove, IL 60047 - Phone
- (708) 899-8150
- NPI assigned
- Mar 6, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Fazio, PSY.D.
- Title
- Owner
- Phone
- (708) 899-8150
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071007381 | IL | Primary |
Addresses
Primary practice location
4160 Route 83
Suite 307
Long Grove, IL 60047
Mailing address
PO Box 613
Channahon, IL 60410-0613
Phone (815) 521-1889
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1488758400000",
"number": "1508306895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 613",
"city": "CHANNAHON",
"state": "IL",
"postal_code": "604100613",
"telephone_number": "815-521-1889",
"fax_number": "815-521-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4160 ROUTE 83",
"address_2": "SUITE 307",
"city": "LONG GROVE",
"state": "IL",
"postal_code": "60047",
"telephone_number": "708-899-8150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR ELIZABETH FAZIO & ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-06",
"last_updated": "2017-03-06",
"status": "A",
"authorized_official_last_name": "FAZIO",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "708-899-8150",
"authorized_official_credential": "PSY.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071007381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.