Elizabeth J Fazio, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007381 Issued in IL

Practice address

211 Robert Parker Coffin Rd
Suite
Long Grove, IL 60047-9616

Phone

(708) 899-8150

Fax

(630) 410-8336

NPI assigned

Oct 5, 2006

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

Practice roles

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

• Dr Elizabeth Fazio & Associates, LLC

  • Clinical Psychologist
  • Long Grove, IL
  • NPI 1508306895
  Authorized official Same address or phone
• Miracare Neuro Behavioral Health, PC

  dba Palos Behavioral Health Professionals

  • Psychologist
  • Palos Heights, IL
  • NPI 1649329251
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1518054386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 GRANT ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394012",
            "telephone_number": "708-899-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ROBERT PARKER COFFIN RD",
            "address_2": "SUITE",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600479616",
            "telephone_number": "708-899-8150",
            "fax_number": "630-410-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Wayne Erickson, PSY.D.
• Heidy Hwang Evans
• Shakeema Alexandra Facey, ARNP
• Fairbanks, LLC
• Mazin Fattouhi, M.D.
• Carolyn Federman, MD
• Felice Block Ma LCPC
• Mary Susan Fidale, LCPC, RNC
• Marek Filipiuk, M.D.
• Benjamin Fischer

• Clinical Psychologist in Long Grove, IL
• Providers in Long Grove, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.